Health Savings Accounts (HSAs) are a smart way to handle medical costs. And thanks to new rules in the One Big Beautiful Bill (OBBB), many Americans who previously didn’t qualify can now open and fund an HSA. Here’s what’s changing.

HSAs: A Quick Refresher

An HSA is a special savings account that helps you set aside money for medical costs. The biggest benefit to these accounts? Taxes. You contribute money before taxes, let it grow tax-free, and withdraw it tax-free for qualified medical expenses. It’s a triple tax break that helps build a cushion for healthcare. And unlike flexible spending accounts (FSAs), the funds in HSAs roll over year to year.

Previously, unless you had a high-deductible health plan (HDHP), strict IRS rules prevented many people from funding an HSA. However, the OBBB, which was passed last summer, opens the door for millions of those people to start this year.

More Plans Qualify in 2026

If you have a bronze or catastrophic plan through the Affordable Care Act (ACA), you’re now eligible for an HSA. In the past, bronze and catastrophic plans didn’t qualify as HDHPs with the IRS, so you couldn’t pair them with an HSA. The OBBB removes this roadblock. This means many lower-income and younger adults who pick bronze or catastrophic plans to keep premiums low will now have access to this tax-advantaged way to save for healthcare costs.

Direct Primary Care Gets a Boost

Direct Primary Care (DPC) is a healthcare model that allows patients to pay a flat monthly fee to a doctor or small practice for unlimited primary care visits. It is straightforward access for minor issues, checkups, or ongoing care without the hassle of insurance claims. Before, the IRS counted this as other coverage, so it didn’t qualify for HSA contributions. Now, as long as monthly fees don’t top $150 per person ($300 for families), DPC won’t block you from funding an HSA, and you can use your HSA money to help cover those fees.

Telehealth Update

HDHPs can now cover telehealth services before the deductible is met without disqualifying you from using an HSA. This wasn’t always the case. In fact, pre-deductible telehealth coverage used to mean you couldn’t contribute to an HSA at all. However, during COVID, Congress temporarily created a safe harbor that let HDHPs cover pre-deductible telehealth services while still allowing contributions to HSAs. The OBBB made this fix permanent.

Healthcare expenses can add up fast, and these updates make HSAs more widely available, especially for people with low-cost health plans.