Health Savings Accounts (HSAs) were a hot topic in the drafting of the “Big Beautiful Bill” (OBBBA). While the original House version proposed major changes, the Senate pared it back, leaving just two notable reforms in the final law.

More Plans Count as HSA-Eligible

Previously, not all Affordable Care Act (ACA) exchange plans qualified as High Deductible Health Plans (HDHPs), which are required for HSA contributions. Some Bronze and Catastrophic plans didn’t meet the deductible and out-of-pocket limits to qualify.

Now, under Section 71307 of OBBBA, all Bronze and Catastrophic ACA plans, whether purchased through the Federal marketplace or a state exchange like Connect for Health Colorado, are considered HDHPs.

Planning consideration: This change expands HSA access to more Coloradans, including many Boulder families and young professionals who opt for lower-cost Bronze plans through the exchange.

Direct Primary Care Arrangements Allowed

Direct primary care (DPC) arrangements, where patients pay a flat monthly or annual fee for primary care services, used to create uncertainty for HSA eligibility.

Under Section 71308 of OBBBA, individuals can now keep HSA eligibility while enrolled in a DPC arrangement, as long as fees don’t exceed $150 per month (individual) or $300 per month (family).

Planning consideration: Boulder has a growing number of concierge and direct primary care practices, popular with families and busy professionals who value personalized care. Now, patients using these services can continue to build HSA savings without penalty.

The Bottom Line

The final law fell short of sweeping HSA reform, but it did create new pathways for eligibility. More marketplace plans now qualify as HDHPs, and direct primary care arrangements no longer threaten HSA contributions.

For Boulder residents, this could mean greater flexibility in pairing local health care options, from Bronze ACA plans to direct primary care practices, with the tax advantages of HSAs.