Referred to the House Committee on Ways and Means.
This bill amends Internal Revenue Code section 223 to allow payments for direct primary care (DPC) service arrangements to be treated as medical expenses for Health Savings Account (HSA) eligibility and distributions. It defines DPC, excludes certain services (most prescriptions, anesthetic procedures, some labs), caps monthly fees at $150 per individual (double if covering more than one), updates inflation-indexing language, requires employers to report aggregate DPC fees on Form W-2, and takes effect for months after December 31, 2025.
Progressives emphasize regressivity; conservatives emphasize market choice
Relative to its intended legislative type, this bill is a focused statutory amendment that clearly targets Internal Revenue Code provisions to permit specified direct primary care arrangements to coexist with HSA eligibility.
This bill amends Internal Revenue Code section 223 to allow payments for direct primary care (DPC) service arrangements to be treated as medical expenses for Health Savings Account (HSA) eligibility and distributions.
It defines DPC, excludes certain services (most prescriptions, anesthetic procedures, some labs), caps monthly fees at $150 per individual (double if covering more than one), updates inflation-indexing language, requires employers to report aggregate DPC fees on Form W-2, and takes effect for months after December 31, 2025.
Technically modest, administrable change with limited controversy, but carries revenue implications and must compete for floor time or attachment to larger vehicles.
Relative to its intended legislative type, this bill is a focused statutory amendment that clearly targets Internal Revenue Code provisions to permit specified direct primary care arrangements to coexist with HSA eligibility. It provides concrete definitions, limits, and reporting requirements and delegates regulatory authority for needed clarifications.
Progressives emphasize regressivity; conservatives emphasize market choice
These are examples from the analysis, not a ranked list of the most-affected groups.
Progressives emphasize regressivity; conservatives emphasize market choice
Sees potential access gains from encouraging primary care relationships, but worries the change chiefly benefits HSA holders and higher earners.
Concerned about tax-advantaged treatment widening health inequities and possibly undermining comprehensive insurance coverage.
Views the bill as a pragmatic, targeted change to expand primary care options and clarify tax treatment, while wanting guardrails and evaluation.
Supportive if administrative details and consumer protections are clarified.
Welcomes a market-driven expansion that increases consumer choice and lets HSAs cover DPC fees.
Sees reduced regulation of primary care relationships and appreciates tax-advantaged flexibility for individuals and employers.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Technically modest, administrable change with limited controversy, but carries revenue implications and must compete for floor time or attachment to larger vehicles.
The bill has not accumulated any surfaced votes yet.
Progressives emphasize regressivity; conservatives emphasize market choice
Technically modest, administrable change with limited controversy, but carries revenue implications and must compete for floor time or atta…
Relative to its intended legislative type, this bill is a focused statutory amendment that clearly targets Internal Revenue Code provisions to permit specified direct primary care arrangements to coexist with HSA eligib…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.