BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2576
                                                                  Page  1

          Date of Hearing:   May 21, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                    AB 2576 (Harkey) - As Amended:  April 22, 2014

          Policy Committee:                              Revenue &  
          Taxation     Vote:                            5-2

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill conforms California tax law to federal tax law with  
          respect to health savings accounts (HSAs) for taxable years  
          beginning on or after January 1, 2014.  In summary, this bill:

          1)Allows eligible individuals to claim an "above the line"  
            deduction for contributions to HSAs in computing their  
            adjusted gross income, and excludes any contributions to an  
            HSA made by an employer on an employee's behalf.

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

          3)Adopts a number of other changes to conform to federal changes  
            to HSAs enacted in 2006, including, among others: 

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

             b)   Permitting participants to make a one-time rollover  
               distribution from an individual retirement account to fund  
               an HSA.

             c)   Eliminating the requirement to prorate HSA contributions  
               based on the number of months of enrollment in a  
               high-deductible health plan in the first year of  
               enrollment.

           FISCAL EFFECT  









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          1)Potentially significant GF costs to Franchise Tax Board (FTB)  
            to administer the changes to forms and systems.

          2)Estimated GF revenue decreases of $80 million, $55 million,  
            and $55 million in FY 2014-15, FY 2015-16, and FY 2016-17,  
            respectively.

           COMMENTS  

          1)  Purpose.   According to the author, this bill would conform  
            California tax law with federal tax law regarding HSAs by  
            providing a tax deduction based on contributions.  The author  
            contends California is currently one of only three states that  
            does not conform.

            AB 2576 encourages the use of HSAs and extends the options for  
            contributing to HSAs to eligible HSA employers.  The author  
            contends encouraging the uninsured to purchase health  
            insurance by allowing this tax deduction will reduce the  
            overall costs associated with providing healthcare to  
            uninsured individuals.

          2)  Health Savings Accounts.   Current state law permits  
            tax-advantaged growth in HSA funds and the use of those funds  
            for qualified medical expenses, conforming to federal rules  
            for Archer medical savings accounts (Archer MSAs).  California  
            has not adopted the federal rules for HSAs, and as a result,  
            California taxpayers will be disadvantaged if they decide to  
            roll over Archer MSAs to HSAs.

            Proponents claim HSAs have helped make healthcare more  
            affordable by allowing families to pay lower premiums under  
            "high-deductible plans" while saving money for medical  
            emergencies in tax-advantaged accounts.  Proponents argue  
            healthcare premiums may rise substantially under the  
            Affordable Care Act, and more Californians may look to  
            high-deductible plans to manage the premium increases.  

            Under federal law, individuals with a high deductible health  
            plan, and no other health plan other than a plan that provides  
            certain permitted coverage, may establish an HSA.  In general,  
            HSAs are tax-exempt trusts or custodial accounts established  
            exclusively to pay for the qualified medical expenses of the  
            account holder, his or her spouse, and any dependents.  Within  
            certain limits, contributions to an HSA are deductible.  HSAs  








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            allow tax-deductible deposits and tax-free withdrawals, as  
            long as the funds are used for qualified medical expenses.  

          3) Opposition.   Opponents argue first that HSAs encourage  
            underinsurance by shifting cost risk to consumers.  Since HSAs  
            are paired with high-deductible health plans, they are most  
            effective at reducing the utilization of heath care, rather  
            than addressing rising health care costs.  Opponents also  
            argue that HSAs favor higher income taxpayers.  In 2008, the  
            US Governmental Accountability Office found the median income  
            of tax filers reporting an HSA contribution was $139,000.   
            According to the report, many HSA participants appear to be  
            using their accounts purely or primarily as a tax-advantaged  
            savings vehicle rather than paying for out-of-pocket health  
            care costs.  The GAO found that 41% of tax filers reporting  
            HSA contributions in 2005 did not withdraw any funds from  
            their accounts at any time during the year.

          4)  Affordable Care Act.   The ACA, passed in March 2010, requires  
            most citizens and legal residents to have health insurance by  
            January 1, 2014.  The ACA outlines the minimum coverage and  
            essential health benefits that must be provided for a plan to  
            qualify for the mandated coverage.  The ACA may reduce the  
            need for HSAs given the expansion of Medicaid coverage.   
            Individuals who would have signed up for an HSA may not do so  
            if they are able to purchase more affordable health care or  
            are covered under Medicaid.  Conversely, the ACA may also  
            encourage the use of HSAs.  Starting with 2014, businesses  
            with 50 or more full-time employees must offer health  
            insurance plans.  These businesses might opt for  
            high-deductible plans that can be coupled with HSAs.  Some  
            experts believe high-deductible plans coupled with HSAs will  
            be the most affordable way to meet the requirements for  
            minimal essential coverage

           Analysis Prepared by  :    Joel Tashjian / APPR. / (916) 319-2081