Congress moves to block abortion from tax-advantaged health savings

What it does

This bill amends federal tax law to prohibit Health Savings Accounts (HSAs), Archer Medical Savings Accounts (MSAs), health flexible spending arrangements, and retiree health accounts from covering abortion expenses, with narrow exceptions for abortions resulting from rape or incest or those necessary to prevent the pregnant woman's death. The bill effectively restricts how individuals can use pre-tax healthcare dollars they have already set aside, carving out abortion from the definition of 'qualified medical expenses' across multiple tax-advantaged health accounts.

Why we flagged it

The bill's operative mechanism is a prohibition on using tax-advantaged healthcare savings for a specific medical procedure. It is not a tax cut, subsidy, or deregulation—it is a narrowing of what counts as a qualified medical expense under existing law.

What the text implies

• The bill applies retroactively to 'amounts paid with respect to taxable years beginning after December 31, 2025,' meaning individuals who have already contributed to HSAs in 2025 may find their existing balances subject to new restrictions on how they can be spent.
• By restricting abortion across HSAs, MSAs, FSAs, and retiree health accounts simultaneously, the bill creates a coordinated reduction in healthcare spending flexibility across all major tax-advantaged health savings vehicles, compounding the practical impact on individuals.
• The 'excluded abortion' carve-out for rape, incest, and life-endangering conditions requires physician certification, creating a gatekeeping mechanism that may delay or complicate access to funds for qualifying abortions.
• Citizens in states with abortion bans or restrictions may find their HSA/FSA funds unusable for abortion even in circumstances where the procedure is legal, creating a federal tax-code barrier independent of state law.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Ordinary citizens lose a pre-existing right to use their own tax-advantaged healthcare savings for a lawful medical procedure. The restriction narrows the scope of medical expenses individuals can cover with HSA/FSA funds they have already contributed, reducing the practical utility of these accounts and effectively increasing the out-of-pocket cost of abortion for those who rely on these savings vehicles.

Named in the bill

Internal Revenue Code Section 223 (HSA), Internal Revenue Code Section 220 (Archer MSA), Internal Revenue Code Section 106 (FSA/HRA), Internal Revenue Code Section 401 (retiree health accounts), U.S. Department of the Treasury, IRS

Where it stands

7 cosponsors: 7 Republicans.

• Jan 24, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Jan 24, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.