IRS Issues HSA Guidance Under OBBBA

The Internal Revenue Service (IRS) has issued Notice 2026-05 which provides guidance on changes relating to health savings accounts (HSAs) enacted under the One, Big, Beautiful Bill Act (OBBBA). The OBBBA expanded access to HSAs in the following ways.

• Allows individuals with high-deductible health plans (HDHPs) to enroll in direct primary care arrangements while remaining HSA eligible as long as the monthly fee does not exceed $150.
• Expands the definition of an HDHP to include bronze and catastrophic health insurance plans purchased on the Exchange under the Patient Protection and Affordable Care Act.
• Extends permanently and makes retroactive the special “telehealth safe harbor” established under the Coronavirus Aid, Relief, and Economic Security (CARES) Act that expired December 31, 2024, for HSA-compatible HDHPs.

The Notice provides guidance on these topics in question and answer format. The Treasury Department and the IRS request comments on the Notice by March 6, 2026.