H.R.1026 - Primary Care Enhancement Act of 2025 (119th Congress)
Summary
H.R.1026, the Primary Care Enhancement Act of 2025, aims to amend the Internal Revenue Code of 1986 to allow individuals with direct primary care (DPC) service arrangements to remain eligible for health savings accounts (HSAs). This bill ensures that DPC arrangements are not treated as health plans for HSA eligibility purposes. It also allows DPC service arrangement fees to be considered medical expenses and adjusts for inflation.
Expected Effects
The bill will likely increase the adoption of direct primary care models by making them more financially accessible through HSAs. This could lead to a shift in how primary care is delivered and financed. The change impacts sections of the Internal Revenue Code related to health savings accounts and employer reporting requirements.
Potential Benefits
- Increased access to direct primary care services for individuals with HSAs.
- Greater flexibility in healthcare choices for consumers.
- Potential for lower healthcare costs through the DPC model.
- Simplification of tax treatment for DPC arrangements.
- Encourages preventative care and stronger patient-physician relationships.
Potential Disadvantages
- The $150 monthly limit on DPC fees might be restrictive in some areas with higher costs of living.
- Potential complexity in reporting DPC fees on W-2 forms for employers.
- May disproportionately benefit higher-income individuals who are more likely to have HSAs.
- Possible administrative burden for the Secretary of Health and Human Services to issue regulations.
- Could lead to a fragmentation of the healthcare system if DPC becomes too separated from traditional insurance models.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution (Preamble), as it aims to improve healthcare access. Congress has the power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States (Article I, Section 8). The bill falls under Congress's authority to regulate taxation and healthcare financing.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).