BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 326
                                                                  Page  1

          Date of Hearing:   May 18, 2009

                     ASSEMBLY COMMITTEE ON REVENUE AND TAXATION
                             Charles M. Calderon, Chair

                 AB 326 (Garrick) - As Introduced:  February 18, 2009

                                      SUSPENSE

          Majority vote.  Tax levy.  Fiscal committee.

           SUBJECT  :  Personal income tax:  Health Savings Account (HSA):   
          deductions 

           SUMMARY  :  Conforms to federal tax law with respect to health  
          savings accounts (HSAs) for taxable years beginning on or after  
          January 1, 2010.  Specifically,  this bill :  

          1)Allows eligible individuals to claim an above-the-line  
            deduction related to their contributions to HSAs in computing  
            their adjusted gross income (AGI).  

          2)Treats an HSA as a tax-exempt trust for tax purposes.  

          3)Excludes from the gross income of the employee any  
            contributions to an HSA made by an employer on the employee's  
            behalf.

          4)Includes HSAs as an approved option in a nontaxable cafeteria  
            plan for employee benefits created by an employer.

          5)Adopts federal changes enacted in 2006 that enhance the HSAs  
            by: 

             a)   Permitting the funds remaining upon termination of  
               health flexible spending arrangements or health  
               reimbursements arrangements to be transferred to HSAs.

             b)   Revising the annual deductible limitation on  
               contributions to HSAs to disregard the amount of the annual  
               deductible under the high deductible health plan (HDHP). 

             c)   Modifying the cost-of-living adjustments for Consumer  
               Price Index for a calendar year to use the 12-month period  
               ending on March 31 of the calendar year rather than the  








                                                                  AB 326
                                                                  Page  2

               12-month period ending on August 31, of the preceding  
               calendar year.

             d)   Eliminating the requirement to prorate the amount of HSA  
               contribution based on the number of months of enrollment in  
               an HDHP for an individual who becomes covered under the  
               HDHP during the taxable year in a month other than January.

             e)   Enacting an exception to the requirement for comparable  
               contributions by employers to permit employers to make  
               larger contributions for non-highly compensated employees  
               than for highly compensated employees. 

             f)   Permitting participants to make a one-time distribution  
               from an individual retirement account (IRA) to fund an HSA.

             g)   Allows a taxpayer to rollover the balance of an existing  
               Archer medical savings account (Archer MSA) to an HSA for  
               taxable years beginning on or after January 1, 2010,  
               without penalty.

             h)   Imposes a penalty for a disqualified distribution equal  
               to 2 % of the distribution amount, rather than 10% as  
               provided by federal law.

             i)   Does not conform to the federal 6% excise tax on excess  
               contributions.

             j)   Imposes a $50 penalty for failing to make required  
               reports.

          6)Takes effect immediately as a tax levy.

           EXISTING FEDERAL LAW:

           1)The Medicare Prescription Drug, Improvement, and Modernization  
            Act of 2003 (Public Law 108-173) established HSAs, beginning  
            in tax year 2004.

          2)Defines an HSA as a tax-exempt trust or custodial account  
            created exclusively to pay for the qualified medical expenses  
            of the account holder and his/her spouse and dependents. 

          3)Allows any balance in an HSA to grow on a tax-free basis.









                                                                  AB 326
                                                                  Page  3

          4)Allows individuals with an HDHP, and no other health plan  
            other than a plan that provides certain permitted coverage, to  
            establish an HSA. 

          5)Allows a deduction for contributions to HSAs when computing  
            AGI, if made by an eligible individual.  Distributions from an  
            HSA for qualified medical expenses of the eligible individual,  
            spouse or dependents are not includible in gross income.  

          6)Defines "qualified medical expenses" as medical expenses  
            including expenses for diagnosis, cure, mitigation, treatment,  
            or prevention of disease, including prescription drugs,  
            transportation primarily for and to such care, and qualified  
            long-term care expenses.  Distributions made for non-qualified  
            medical expenses are includible in gross income and also  
            subject to an additional 10% tax, unless the distributions are  
            made after death, disability, or after the individual attains  
            the age of Medicare eligibility.  

          7)Specifies that medical expenses paid via distributions that  
            are excludable from income may not be claimed as medical  
            expenses for purposes of reporting itemized deductions.

          8)Excludes contributions to an HSA from income and employment  
            taxes if made by the employer.  Eligible individuals include  
            those covered by high-deductible health plans and, in general,  
            are not eligible for other health coverage.  

          9)Specifies the maximum aggregate annual contribution that may  
            be made to an HSA by or on behalf of the eligible individual,  
            which is the lesser a) 100% of the annual deductible under the  
            HDHP, or, b) $3,000 in the case of self-only coverage and  
            $5,950 in the case of family coverage for 2009 tax year.   
            Those limits are indexed for inflation.  

          10)Allows employers to make larger HSA contributions for  
            non-highly compensated employees than for highly compensated  
            employees.  

          11)Includes the balance remaining in an HSA after the death of  
            the eligible individual in the gross estate of the decedent  
            unless the decedent's spouse is the beneficiary of the HSA.   
            In that case, the HSA balance is deducted in computing the  
            taxable estate and the HSA passes to the surviving spouse,  
            subject to the general restrictions on, and taxation of,  








                                                                  AB 326
                                                                  Page  4

            distributions.

          12)Imposes numerous reporting requirements related to HSAs.   
            Employer contributions to the HSAs must be reported on the  
            employees Form W-2.  In addition, the trustee of the HSA must  
            report information on distributions, contributions, and other  
            required information to the Secretary of the Treasury.  Health  
            insurance providers must report information as required by the  
            Secretary of the Treasury.

          13)Authorizes a direct transfer of funds from the health  
            Flexible Spending Arrangements (FSAs) or Health Reimbursement  
            Arrangements (HRAs) to an HSA, but limits the amount that may  
            be transferred to an amount equal to the lesser of (a) the  
            balance in the health FSA or HRA as of September 21, 2006, or  
            (b) the balance in the health FSA or HRA as of the date of the  
            transfer.  

          14)Authorizes a one-time contribution to an HSA of amounts  
            distributed from an IRA as a direct trustee-to-trustee  
            transfer.  Excludes the transfer amount from the gross income  
            of the accountholder and from the 10% penalty on early IRA  
            distributions. 

          15)Allows tax-benefited medical accounts called Archer MSAs.   
            The Acher MSAs create a tax-exempt trust or custodial account  
            for the benefit of the account holder.  Rules similar to those  
            for IRAs apply to the Archer MSAs.  Archer MSAs do not provide  
            the assistance needed by many working families and do not  
            receive widespread support or participation.  As part of the  
            legislation enacting HSAs, participants of Archer MSAs are  
            able to transfer or rollover their balances from the Archer  
            MSAs to a new HSA.  This transfer specifically is not treated  
            as a disqualifying distribution.

           EXISTING STATE LAW  allows tax-benefited growth and use of funds  
          for qualified medical expenses, conforming to the federal rules  
          for Archer MSAs.  However, California has not adopted the HSAs  
          created as part of the 2003 federal legislation.  Due to the  
          lack of conformity, California taxpayers will be disadvantaged  
          financially if they rollover (transfer) their Archer MSAs to  
          HSAs.  Although specifically approved for federal tax purposes,  
          the transfer is a disqualified distribution for California tax  
          purposes, includable in income and subject to tax as well as an  
          additional 10% penalty.  Similarly, transfers of funds from IRAs  








                                                                  AB 326
                                                                  Page  5

          will be treated as income subject to tax, and potentially  
          subject to the 2 % penalty for early distribution.

           FISCAL EFFECT  :  Franchise Tax Board (FTB) staff estimate a  
          revenue loss from this bill of $18 million in fiscal year (FY)  
          2009-10, $55 million in FY 2010-11, and $60 million in FY  
          2011-12.
           
          COMMENTS  :   

          1)The author states, "Health Savings Accounts [HSAs] were  
            created with the passage of the 2003 Medicare bill signed by  
            President Bush.  HSA's allow for individuals to plan ahead for  
            qualified medical expenses on a tax free basis. HSA's have  
            also been used to defray the costs associated with High  
            Deductible Health Plans. HDHP's & HSA's give individuals  
            further flexibility when determining what type of health care  
            coverage is best for them.  HSA's and HDHP's offer consumers  
            security, affordability, flexibility and they are 100%  
            portable.  By encouraging contributions to HSA's we make  
            insurance that much more affordable. 

          "AB 326 encourages the use of HSA's by allowing for a tax  
            deduction for contributions made to an HSA by, or on behalf  
            of, an eligible individual.  AB 326 would extend the option of  
            contributing to any eligible HSA to employers who may be  
            interested in exploring cost-effective ways to help employees  
            defray medical expenses. 

          "Encouraging the uninsured to purchase health insurance by  
            allowing this tax deductible option, will reduce the number of  
            uninsured, and accordingly, reduce costs associated with  
            providing healthcare to the uninsured.  Reducing healthcare  
            costs will make healthcare insurance more affordable for all.   
            Furthermore, allowing employers to contribute to  
            tax-deductible HSA's on behalf of their employees provides a  
            low-cost mechanism to offer their employees an additional  
            benefit. Many employers would provide some form of health  
            benefit to their employees if it were cost efficient. 

          "This is a simple conformity measure, bringing California inline  
            with federal HSA provisions.  Currently, California is one of  
            only five states that taxes contributions to Health Savings  
            Accounts. Given our current healthcare crisis, we should be  
            creating incentives for people to save for future healthcare  








                                                                  AB 326
                                                                  Page  6

            costs, and AB 326 creates one such incentive."

          2)Proponents state that HSAs, when combined with HDHPs, present  
            an option for business to provide some health insurance for  
            employees rather than none at all.  Proponents point to the  
            growth of HSA use and cite data that shows a third of all  
            HSA/HDHP purchases were made by those previously uninsured.   
            According to proponents, use of HSAs help individuals take  
            control of how their health care dollars are spent, and enable  
            them to save for future medical expenses and retiree-health  
            expenses on a tax-free basis.  In fact, HSAs improve upon  
            existing tax-deductible saving options because both the  
            employer and employee may contribute to an employee's HSA  
            without increasing the employee's taxable income.  Also,  
            unspent funds roll over from year to year and move with an  
            employee.  Because California is one of only a few states that  
            do not permit HSAs, California employees of multistate or  
            multinational employers will not enjoy the tax advantages of  
            HSAs, thereby paying more for the same medical coverage. 

          Proponents also point out that HSAs provide one the fastest  
            growing coverage options for those currently lacking health  
            insurance coverage, and, while HSAs are not for everyone, 6.1  
            million people were covered by HSAs/HDHPs in January of 2008.   
            Proponents argue that, in light of the skyrocketing cost of  
            healthcare, California taxpayers are continually searching for  
            help in easing the high price of health services. 

          Finally, the proponents believe that this measure will save  
            California taxpayers much confusion and heartache in filling  
            out their income tax forms. 

          3)Opponents state that this bill amounts to a tax giveaway for  
            holders of HSAs because they already have the financial  
            resources to afford health insurance.  According to the  
            opponents, this bill would benefit only high wage earners, as  
            demonstrated in a January 2006 report from the Government  
            Accountability Office, and would do nothing to make health  
            care more affordable for the uninsured and low-income earners  
            or will force people on Medicare or other assistance programs  
            to buy care they cannot afford.  

          Opponents also argue that HSAs actually limit consumer choice  
            and ultimately cost low- and middle-income workers more money  
            because HSAs must be coupled with HDHPs.  Opponents contend  








                                                                  AB 326
                                                                  Page  7

            that HDHPs are bad for workers as they discourage sick workers  
            and their families from seeking care for routine illnesses,  
            potentially leading to subsequent health care costs that are  
            much higher than they would have been with early treatments.   
            Opponents believe that this cycle of high barriers to care and  
            worsening illnesses hurts working families.  Furthermore,  
            Harvard Medical School researches found that HSAs are more  
            costly for women, largely because women need routine medical  
            exams, mammograms, vaccines, Pap tests, birth control and  
            pregnancy-related services. 

          Additionally, opponents assert that HSAs hurt the health system  
            as a whole because the health system needs to spread its risk.  
             Taking healthy individuals out of the insurance pool  
            increases the cost to those in need of more extensive health  
            insurance.  Finally, opponents argue that this measure would  
            result in a revenue loss that could impact the provision of  
            critical firefighting and public safety services and that  
            health care costs must be dealt with by containing health care  
            costs, harnessing the power of group purchasing and regulating  
            health insurers more efficiently. 

          4)Committee staff note all of the following:

             a)   California adjustments  .  Because California has not  
               conformed to any of the federal HSA provisions, a taxpayer  
               taking a deduction on his/her federal personal income tax  
               return is required to increase his/her AGI on the  
               California personal income tax return by the amount of that  
               deduction.  In addition, any interest earned on the HSA  
               account must be added to the taxpayer's AGI for California  
               tax purposes, and any contributions made by the taxpayer's  
               employer to the HSA, must be included in the taxpayer's  
               AGI. 

              b)   Tax incentive for high-income taxpayers  .  An HSA is a  
               savings account that provides for tax-deductible deposits  
               and allows tax-free withdrawals, as long as the funds are  
               used for qualified medical expenses.  In contrast, a  
               traditional IRA allows tax-deductible contributions but  
               subject distributions to tax.  Further, in the case of a  
               Roth IRA, contributions to the account are taxable, but  
               qualified distributions are tax-free.  In addition, both a  
               traditional IRA and a Roth IRA have income limitation  
               restricting eligibility.  HSAs have no income restrictions  








                                                                  AB 326
                                                                  Page  8

               and are available to anyone.  In its 2006 report, the  
               United States Government Accountability Office found that  
               the median income of tax filers reporting an HSA  
               contribution in 2004 was $133,000 and 51% of those tax  
               filers contributing to HSAs had an income of $75,000 or  
               more.  It appears that HSAs disproportionately benefit  
               high-income individuals.  

              c)   Implementation Concerns  .  This bill does not address the  
               impact of HSAs created before the effective date of this  
               bill.  Without addressing the tax treatment of HSAs created  
               before 2010, there might be implementation concerns because  
               part of the HSA will be pre-tax dollars and part will be  
               post-tax dollars.  Additional legislation or regulations  
               would be required to provide guidance to FTB with respect  
               to treatment of qualified and disqualified distributions  
               from such HSAs.  Because California is one of only four  
               states that have not adopted HSAs, there may be  
               implementation concerns from employees that move into  
               California from a conforming state.

              d)   Partial Conformity  .  An alternative step to full  
               conformity available would be to remove the penalty  
               associated with rollovers of Archer MSA and IRA funds,  
               which are both allowed tax-free for federal purposes.  As  
               mentioned above, the Archer MSA rollover is a disqualified  
               distribution and subjected to both income tax and a penalty  
               for disqualified distributions.  Similarly, the transfer of  
               funds from an IRA is subject to income tax and might be an  
               early withdrawal subject to a penalty (if the  
               transferor/IRA owner is less than age 59  when the  
               transfer is made).  California could choose to make those  
               distributions or transfers not subject to penalty.

              e)   Conformity Bill.   This bill fully conforms California  
               law to federal HSA provisions beginning with tax year 2010.  
                California does not automatically conform to federal law  
               but instead considers each provision individually.  The  
               last California-federal conformity bill was enacted in 2005  
               [AB 115 (Klehs), Chapter 691, Statutes of 2005].  It  
               appears that the omnibus California-federal conformity bill  
               would be a more appropriate vehicle for conforming to the  
               federal HSA provisions. 

           5)Related Legislation  .  Committee staff notes that the issue of  








                                                                  AB 326
                                                                  Page  9

            conformity to federal HSA legislation has been proposed in  
            every legislative session since the federal law was enacted.  

          AB 2292 (Garrick), introduced in the 2007-08 Legislative  
            Session, is similar to this bill, but would have applied to  
            taxable years beginning on or after January 1, 2008. AB 2292  
            was held in this committee. 

          AB 84 (Nakanishi/Smyth), introduced in the 2007-08 legislative  
            session, is similar to this bill.  AB 84, as amended on March  
            12, 2007, would have conformed to federal HSA provisions  
            starting with taxable year 2008.  AB 84 was held in this  
            committee. 

          AB 142 (Plescia), introduced in the 2007-08 legislative session,  
            is nearly identical to this bill.  That bill would have  
            conformed to federal HSA provisions starting with taxable year  
            2008, which is the same as this bill; however, AB 142  
            specified a different nonconformity period than this bill.  AB  
            142 was held in the Senate Revenue and Taxation Committee. 

          AB 245 (DeVore), introduced in the 2007-08 legislative session,  
            is identical to AB 142.  AB 245 was held in this committee.

          SB 25 (Maldonado and Runner), introduced in the 2007-08  
            legislative session, is identical to this bill.  SB 25 was  
            held in the Senate Revenue and Taxation Committee. 

          SBx1 10 (Maldonado), introduced in the 2007-08 legislative  
            session, is nearly identical to this bill, except that  
            conformity to the federal HSA provisions would apply starting  
            with taxable year 2006.  SBx1 10 failed to pass the Senate  
            Health Committee.   




           
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          American's Health Insurance Plans
          Association of California Life & Health Insurance Companies
          California Association of Health Plans








                                                                  AB 326
                                                                  Page  10

          California Association of Health Underwriters
          California Chamber of Commerce
          California Medical Association
          California Retailers Association
          California Chiropractic Association
          California Society of Enrolled Agents
          California Taxpayers' Association 
          John Deere
          Health Net
          National Federation of Independent Business

           Opposition 

           Amalgamated Transit Union
          American Federation of State, County and Municipal Employees,  
          AFL-CIO
          California Conference of Machinists
          California Federation of Teachers
          California Labor Federation
          California Nurses Association
          California Professional Firefighters
          California School Employees Association
          California Tax Reform Association
          California Teamsters Public Affairs Council
          Engineers and Scientists of California
          IFPTE Local 21
          International Longshore and Warehouse Union
          San Diego County Court Employees Association
          Strategic Committee of Public Employees, Laborers' International  
          Union of North America
          UNITE HERE!
          United Food and Commercial Workers Union, Western States Council

           
          Analysis Prepared by  :  Oksana G. Jaffe / REV. & TAX. / (916)  
          319-2098