Starting January 1, 2026, the United States Health Savings Account (HSA) system will undergo a change due to fiscal and spending policies derived from the “One Big Beautiful Bill” (OBB) law, implemented by the Trump administration. On December 9, the IRS announced the upcoming changes, which will allow individuals with Bronze-level and catastrophic health plans to access these accounts tax-free, regardless of whether they meet the technical definition of a high-deductible health plan (HDHP). Additionally, the new regulation grants permanent access to telemedicine and allows the use of HSA funds to cover direct primary care (DPC) services, making it easier for millions of citizens to save for their medical expenses more flexibly and efficiently.
Main changes
The HSA program is a tool that allows individuals and employers to contribute tax-free money to cover medical needs. Following the announcement of new changes to the program by the IRS last December 2025, its operation will change starting January 1, 2026. Until now, the 2025 regulations limited annual contributions to $4,300 for individuals and $8,550 for families, whereas now the intention is that these benefits will not be limited only to those with traditional high-deductible insurance plans. To understand these changes, it is necessary to understand that an HDHP is characterized by having low monthly premiums in exchange for higher annual deductibles.
With the new changes, this technical nuance will not be considered for certain users. Now, those who have bronze or catastrophic plans—known for their low premiums but high out-of-pocket costs—will be compatible with HSA accounts. According to the new regulations, this inclusion “expands the ability of people enrolled in these plans to contribute to HSAs, which they generally have not been able to do in the past.” The most relevant point for consumers is that these plans do not need to be purchased through an official insurance marketplace (exchange) to qualify, which opens the door to much broader possibilities for beneficiaries.
Telemedicine and direct primary care
Another aim of the One Big Beautiful Bill is the consolidation of remote care. What began as a temporary measure is now intended to be permanent. Telemedicine and remote care services can be used before reaching the health plan deductible without the user losing eligibility to contribute to their HSA. In addition to digitalizing healthcare, the OBB also aims to integrate more personal care models. Those enrolled in Direct Primary Care (DPC) arrangements will now be able to make contributions to their accounts freely. This update, which also takes effect on the first day of 2026, allows citizens to use their tax-free HSA funds to pay for the fees of these direct medical services.
It is worth noting that, essentially, HSAs will remain intact in terms of ownership. The account belongs to the individual and continues to do so even if they decide to change jobs. The accumulated funds can be used for anything from doctor visits and medical equipment to allergy medications and dental services.
With these changes, the administration aims to give citizens greater control over their health-related funds, removing bureaucratic barriers that previously prevented lower-income earners or users of economical plans from benefiting from the tax advantages of health savings.
Frequently asked questions
What new plans will be able to have an HSA account in 2026?
Starting in January, bronze and catastrophic plans will be HSA-compatible. It will no longer be mandatory to meet the technical definition of a high-deductible health plan (HDHP) to start saving tax-free.
What changes are there for telemedicine and DPC services?
Access to telemedicine before reaching the deductible is now permanent. In addition, HSA funds can now be used tax-free to pay for Direct Primary Care (DPC) fees.
Do I lose my money if I change jobs?
No. The HSA account is your property and portable. The money stays with you even if you change jobs, and you can use it for medical, dental, or prescription expenses whenever you need.