4 OBBBA Benefits Changes Finance Leaders Should Know

Heads up, Finance pros: HR might be coming to you soon for input and approval on new OBBBA benefits changes.

Much of the media coverage of the One Big Beautiful Bill Act (OBBBA) has focused on overtime pay and tax relief, but the new legislation also reshapes the benefits landscape in ways that directly affect margin, EBITDA and long-term budget stability.

Here’s what Finance teams need to know now:

The Financial Impact Behind the Headlines

Updates to HSAs, dependent care FSAs, direct primary care arrangements, and Trump Accounts can affect reserves, payroll tax revenue, and compliance risk.

Failing to adapt benefits offerings can carry a hidden cost. In a recent webinar, employee benefits and ERISA attorney Jewell Lim Esposito noted that employees may be concerned if they don’t receive some of the benefits permitted under the new OBBBA rules. 

For Finance, employee dissatisfaction could lead to increased turnover and recruitment costs, along with cash outflows for severance, hiring, onboarding, and lost productivity. With 2026 budgets approaching, overlooking these changes could create misaligned forecasts or midyear cash flow pressures.

Telehealth Relief for HSAs and HDHPs

The OBBBA benefits changes allow first-dollar telehealth coverage under HDHPs without disqualifying HSAs, retroactive to January 1, 2025. Telehealth visits generally cost less than in-person appointments and can improve outcomes by expanding access and encouraging early intervention. Rising healthcare costs make broader telehealth adoption a potential lever for cost control and improved care.

Take these steps to stay ahead of the changes:

• Reassess HSA contribution projections for 2025–2026 to anticipate pre-tax contribution shifts and payroll tax impacts.
• Adjust reserves for shifts in claims patterns to ensure budgets reflect potential changes in healthcare costs.
• Update payroll tax calculations for increased pre-tax contributions to avoid under- or overestimating tax obligations.

Direct Primary Care Arrangement Fees and HSAs

Starting January 1, 2026, as part of the OBBBA benefits changes, fees for direct primary care arrangements under $150 per month for individuals ($300 for families) will qualify as HSA-eligible medical expenses. Previously, it was unclear whether fees for direct primary care arrangements qualified as HSA-eligible medical expenses, creating uncertainty for employees using these arrangements alongside their HSAs.

Here’s what to put on your team’s to-do list:

• Model adoption rates to estimate HSA contributions and payroll tax effects to support accurate forecasting and reserve planning.
• Review healthcare reserves for predictable DPC-related expenses to prevent unexpected claims from affecting budgets.
• Validate payroll and reporting systems for accurate DPC tracking to ensure compliance and financial reporting accuracy.

Increased Dependent Care FSA Limits

Another component of the OBBBA benefits changes raises maximum contributions for dependent care FSAs from $5,000 to $7,500 ($3,750 for married employees filing separately) in 2026. Higher pre-tax contributions reduce taxable payroll and employer payroll tax revenue.

The new dependent care FSA limits for 2026 require Finance to adjust projections and evaluate potential budget impacts. Focus on these key actions:

• Integrate updated FSA limits into payroll tax projections to keep taxable wage base and cash flow estimates accurate.
• Calculate the potential budget impact if employees maximize contributions to avoid unexpected expense spikes.
• Confirm nondiscrimination testing and reporting with HR to reduce audit risk and maintain compliance.

Trump Accounts – Investment Accounts for Children

Effective July 4, 2026, employees can contribute up to $5,000 per child annually to Trump Accounts, with employers able to contribute up to $2,500. Contributions are excluded from taxable income, creating a recurring cost with EBITDA impact.

Finance should note, Esposito stressed, that Trump Account contributions cannot be discriminatory – for example, they cannot favor company owners or highly compensated employees. A formal written plan document is required to define eligibility and ensure compliance, preventing plans from disproportionately benefiting certain groups of employees in violation of federal law.

To manage the financial and operational implications of Trump Accounts:

• Set internal budget limits for employer contributions to manage cash outflows and EBITDA impact.
• Incorporate flexibility into financial models for regulatory changes to mitigate risk from potential rule updates.
• Update payroll and reporting systems for accurate account tracking to maintain proper accounting and compliance.

Preparing Finance for OBBBA Benefits Changes in 2026

These changes expand employee choice while affecting margins, taxes, and compliance. Finance teams can protect cash, maintain forecasting accuracy, and reduce unplanned risk by:

• Testing budgets against high adoption scenarios and potential turnover costs – helping anticipate financial pressure and avoid surprise shortfalls.
• Updating accruals and reserves for retroactive and upcoming liabilities – ensuring the balance sheet reflects potential future obligations.
• Tracking IRS and regulatory guidance as OBBBA implementation evolves – allowing Finance to adapt quickly and avoid compliance penalties.
• Staying closely synced with HR – timely, coordinated action is the best defense against budget shocks and midyear financial surprises from shifting benefit enrollments and participation.

By anticipating these OBBBA benefits changes and aligning with HR, Finance can ensure benefits strengthen competitiveness without compromising financial stability.