Bipartisan HSA Improvement Act of 2018

This bill amends the Internal Revenue Code to modify rules for health savings accounts (HSAs) regarding eligibility and interactions with other tax-favored health accounts.

The bill specifies that receiving or being eligible to receive certain employment-related items and services at an employer-sponsored (e.g., an on-site clinic) or retail health care facility is not considered health care coverage that disqualifies an individual from participating in an HSA. The items and services include

• physical examinations,
• immunizations,
• drugs other than a prescribed drug,
• treatment for injuries occurring in the course of employment,
• drug testing as a condition of employment,
• hearing or vision screenings, and
• other similar items and services that do not provide significant benefits in the nature of medical care.

The bill also (1) allows an eligible individual to make HSA contributions if a spouse has a flexible spending arrangement (FSA) as long as the FSA does not also reimburse the expenses of the spouse with the HSA, and (2) modifies the rules for using FSA or a health reimbursement arrangement terminations or conversions to establish an HSA.