From Capitol Hill to Your Wallet: Advocacy for Your Benefit
Benjamin Cole
Head of Compliance
Last week, I had the privilege of attending the ECFC Advocacy Summit in Washington, D.C. The Employers Council on Flexible Compensation (ECFC) has continuously convened industry leaders, benefits professionals, and policy advocates to meet directly with Congressional staffers and make the case for modernizing America's tax-advantaged health and dependent care benefit programs.
As Head of Compliance at Flex, where we process HSA and FSA payments for ecommerce merchants every day, I see firsthand how the design of these accounts shapes real decisions for real people: whether they can afford the medication their doctor prescribed, whether they can keep a caregiver for an aging parent, whether they can put their child in a quality daycare. Legislation matters and advocacy translates legislation into action.
In this post, I’ll provide a breakdown of the three most critical asks that we brought to Congressional staffers, why each one matters, and most importantly what you can do right now to make your voice heard.
1. Let Medicare, TRICARE, and Indian Health Service Beneficiaries Receive Employer HSA Contributions
The Issue
Under current law, seniors enrolled in Medicare and active-duty military families covered by TRICARE are barred from contributing to or receiving employer contributions into a Health Savings Account (HSA). The same restriction applies to individuals who receive care through the Indian Health Service (IHS). This is not a minor technicality. It means that millions of Americans who have worked a lifetime and earned these coverages are cut off from one of the most powerful tax-advantaged tools available.
The HSA Modernization Act (H.R. 548, 119th Congress), introduced by Rep. Beth Van Duyne (R-TX) along with Reps. Crenshaw and Meuser, would directly address this by amending the Internal Revenue Code to remove these restrictions thus allowing Medicare Part A enrollees, TRICARE-covered individuals, and IHS recipients to contribute to and receive employer contributions into HSAs.
Why It Matters
The numbers are stark. Millions of people on Medicare spend a significant portion of their fixed incomes on healthcare costs including premiums, copays, prescription drugs, and other out-of-pocket expenses. For veterans and their families covered by TRICARE, the financial strain is compounded by the sacrifices they've already made. For Native American communities served by the IHS, access to supplemental tax-advantaged savings could meaningfully reduce healthcare disparities. There is no policy rationale for excluding these populations from HSA eligibility. It is a legacy restriction that punishes the very people who have done everything right.
What You Can Do
Find your representatives at www.congress.gov/members/find-your-member.
Call or email their offices and ask them to co-sponsor or support H.R. 548, the HSA Modernization Act.
Use this message: "I am a constituent and I urge you to support H.R. 548, the HSA Modernization Act. Seniors on Medicare, our veterans on TRICARE, and Native Americans receiving IHS care should not be excluded from contributing to or receiving employer contributions into Health Savings Accounts. Please co-sponsor this bill."
2. Help Caregivers by Allowing HSA/FSA Use for Parents and Inlaws
The Issue
Under current rules, HSA, FSA, HRA, and medical savings account funds can only be used for the account holder, their spouse, and their tax dependents. This means that an adult child caring for an aging parent, spending out-of-pocket for their parent's prescriptions, doctor visits, or medical equipment, cannot use pre-tax benefit dollars to cover those expenses, unless that parent qualifies as a tax dependent. For the millions of Americans that are simultaneously caring for aging parents and raising children of their own, this is a painful and unnecessary restriction.
The Lowering Costs for Caregivers Act (S. 1565 / H.R. 138) is a bipartisan, bicameral bill that would fix this directly. Introduced in the House by Rep. Vern Buchanan and in the Senate by Senators Jacky Rosen (D-NV), Bill Cassidy (R-LA), and Marsha Blackburn (R-TN), the bill would amend the tax code to allow HSA, FSA, HRA, and MSA funds to be used for the qualified medical expenses of a parent or parent-in-law, regardless of dependent status.
Why It Matters
Over 63 million Americans serve as unpaid family caregivers. On average, family caregivers spend more than $7,200 out-of-pocket each year caring for a loved one, roughly 26% of their income. Nearly half report negative financial consequences: stopped saving, taken on debt, left bills unpaid, or struggled to afford basics. More than 95 leading organizations, led by AARP, have sent a letter to Congress urging passage of this bill. This is not a partisan issue. Caring for a parent is a universal human experience. The tax code should support it, not penalize it.
What You Can Do
Find your House and Senate representatives at www.congress.gov/members/find-your-member.
Call or email and ask them to co-sponsor both and support S. 1565 / H.R. 138, the Lowering Costs for Caregivers Act.
Use this message: "I urge you to co-sponsor and support the Lowering Costs for Caregivers Act (S. 1565 / H.R. 138). Millions of Americans are spending thousands of their own dollars caring for aging parents. They should be able to use their pre-tax HSA and FSA funds to cover a parent's medical expenses, regardless of dependent status. Please support this bipartisan bill."
3. Raise the DCFSA Limit to $15,000 and Index It to Inflation
The Issue
The Dependent Care Flexible Spending Account (DCFSA) allows working families to set aside pre-tax dollars for childcare, elder care, and other qualifying dependent care expenses. Congress set the original limit at $5,000 in 1986 and, until July 2025, never updated it. The One Big Beautiful Bill Act finally raised the limit to $7,500 for plan years beginning in 2026, which was a meaningful step forward. But it was not enough, and the new limit is still not indexed to inflation.
ECFC advocates asked Congress to go further: raise the DCFSA limit to $15,000 and index it to inflation so that it never again becomes frozen in time.
Why It Matters
The original $5,000 limit set in 1986 would be worth approximately $13,700 in today's dollars when adjusted for inflation. Childcare costs have risen dramatically in many parts of the country, full-time daycare for a single child exceeds $20,000 per year. The $7,500 limit, while better than $5,000, still forces families to pay the vast majority of their childcare costs with after-tax dollars. A $15,000 limit would finally create a meaningful, lasting benefit that keeps pace with economic reality. Working families, particularly women who disproportionately bear caregiving responsibilities, deserve a benefit that genuinely moves the needle.
What You Can Do
Find your representatives at www.congress.gov/members/find-your-member.
Call or email and ask them to support raising the DCFSA limit to $15,000 and indexing it to inflation.
Use this message: "I urge you to support legislation raising the Dependent Care FSA limit to $15,000 and indexing it to inflation. The current $7,500 limit still doesn't reflect the true cost of childcare and elder care. Working families deserve a benefit that keeps pace with what they actually spend."
Share your childcare cost story with your representative's office. Real numbers from real constituents are powerful.
The Bottom Line: Advocacy Works, But Only If You Show Up
The ECFC Advocacy Summit is a reminder that the rules governing our benefits accounts are not fixed. They are the product of legislative choices that can be changed when enough people make their voices heard. These three issues are not abstract policy debates. They are real decisions about whether a senior on Medicare can save for a prescription, whether a working parent can afford daycare, whether an adult child can use pre-tax dollars to help a parent in need.
You don't need to come to Washington, D.C. to make a difference. A phone call to your representative's office, a brief email, a social media post with your story, these actions add up. Congressional staffers track constituent contacts. They report them upward. They matter.
Take five minutes today. Find your member of Congress at congress.gov/members/find-your-member and pick one issue from this list to act on. The healthcare benefits system touches every American life. It's worth fighting for.
Benny Cole is Head of Compliance at Flex, where the team works to make HSA and FSA payments seamless for ecommerce merchants and the consumers they serve. The views expressed in this post reflect the author's professional perspective and advocacy positions. This post does not constitute legal or tax advice.
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