The biggest recent change in HSAs was the June 2015 Supreme Court decision granting the right of same-sex couples to marry nationwide following their earlier decision striking down the Defense of Marriage Act of 1996 provision that a marriage is a state-sanctioned union between a man and a woman. Going forward, under most aspects of federal tax law, including the application of those provisions to HSAs, a state-recognized marriage is a marriage. The federal tax code does not recognize other relationships, however. Chief among them is domestic partners.

These individuals, even though they may be covered on the health plan, are not treated as spouses for HSA purposes. This different treatment creates some opportunities and places some restrictions on these individuals’ actions and the tax consequences of certain actions.

In most areas of life, this different treatment results in less flexibility and perhaps less benefit for these relationships. In at least one important area, though, HSAs create an opportunity that other tax-advantaged reimbursement accounts do not.

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