S. 3224Senate118th Congress (2023-2025)In Committee

Chronic Disease Flexible Coverage Act

Sponsored by John ThuneSen. John Thune (R-SD)
Introduced November 2, 2023

AI-Generated Summary

Updated January 20, 2026 at 12:43 PM UTC

The Chronic Disease Flexible Coverage Act makes IRS guidance into law, saying that certain services and items for chronic conditions count as preventive care for the deductible safe‑harbor rule that applies to high‑deductible health plans (HDHPs) and health savings accounts (HSAs). This change affects people with HDHPs and HSAs, as well as insurers and health‑care providers who offer those plans.

Key Provisions

  • Treats additional preventive‑care services and items for chronic conditions as meeting the preventive‑care deductible safe‑harbor under the Internal Revenue Code, following IRS Notice 2019‑45.
  • Gives those services the same legal effect as if they were directly included in the statute.
  • Specifies that this rule does not change any other IRS rules or guidance on preventive services.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

November 2, 2023

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SenateIntro Referral

Introduced in Senate

November 2, 2023

SenateIntro Referral

Read twice and referred to the Committee on Finance.

November 2, 2023

Floor Debate

4 members

What members said about S. 3224 on the floor

2 Republicans2 Democrats
John Barrasso
Sen. John BarrassoR-WY · Nov 2, 2023

Madam President, today, I have joined Senators Manchin, Risch, Cardin, Boozman, and Hirono in introducing the Compacts of Free Association Amendments Act of 2023. In the House of Representatives,…

Alex Padilla
Sen. Alex PadillaD-CA · Nov 2, 2023

Madam President, I rise to introduce the Wildland Firefighter Fair Pay Act to permanently increase the pay caps of some of the United States' most hard-working employees, who risk their lives to keep…

John Thune
Sen. John ThuneR-SD · Nov 2, 2023

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Nov 2, 2023

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

John Thune
Sen. John ThuneR-SD · Nov 2, 2023

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

Latest available legislative text

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Introduced in SenateIssued November 2, 2023

II

118th CONGRESS

1st Session

S. 3224

IN THE SENATE OF THE UNITED STATES

November 2, 2023

Mr. Thune (for himself and Mr. Carper) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To codify Internal Revenue Service guidance relating to treatment of certain services and items for chronic conditions as meeting the preventive care deductible safe harbor for purposes of high deductible health plans in connection with health savings accounts.

1.

Short title

This Act may be cited as the Chronic Disease Flexible Coverage Act.

2.

Services and items for chronic conditions treated as preventive care

(a)

In general

The additional preventive care services and items for chronic conditions that may be treated as preventive care for purposes of section 223(c)(2)(C) of the Internal Revenue Code of 1986 as set forth in IRS Notice 2019–45 shall have the same force and effect as if included in the enactment of this Act.

(b)

No inference

To the extent not inconsistent with this subsection, no inference shall be made from such subsection with respect to such other rules or guidance as the Secretary has provided, or may provide, with respect to preventive services for purposes of section 223(c)(2)(C) of such Code.