Whereas Health Savings Accounts (HSAs) were created in section 223 of the Internal Revenue Code of 1986 as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 ( Public Law 108–173 ); Whereas, December 8, 2018, marks the 15th anniversary of the enactment of Health Savings Accounts; Whereas an increasing number of Americans are facing rising out-of-pocket health care costs as they struggle to find affordable coverage; Whereas Health Savings Accounts help more than 20 million Americans pay for out-of-pocket health care costs; Whereas there are more than 23 million Health Savings Accounts holding more than $51,000,000,000 in assets; Whereas a Health Savings Account paired with HSA-qualified insurance provides protection against future high or unexpected medical bills; Whereas a HSA provides triple tax savings including— (1) tax deductions when funds are deposited into the account; (2) tax-free earnings through investment; and (3) tax-free withdrawals for qualified medical expenses; Whereas funds in Health Savings Accounts do not expire at the end of each calendar year and roll over automatically from one year to the next, accumulating over time; Whereas there are no use it or lose it rules for HSAs; Whereas funds in a Health Savings Account may be used to pay for current medical expenses, or saved for future needs, such as— (1) medical expenses not covered by health insurance; (2) health insurance premiums or out-of-pocket medical expenses if unemployed; (3) out-of-pocket medical expenses after retirement; (4) out-of-pocket expenses for individuals covered by Medicare; and (5) long-term care expenses and insurance; Whereas funds in Health Savings Accounts may be invested in the same types of investments permitted for Individual Retirement Accounts; Whereas Health Savings Account owners control all the decisions about— (1) which financial institution to hold deposits in the account; (2) how much money to deposit into the account