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119-hr-1026119th CongressWALLET

Primary Care Enhancement Act of 2025

Sponsored By: Representative Smucker, Lloyd [R-PA-11]

Introduced

Summary

This bill would make direct primary care fees eligible for Health Savings Account (HSA) medical expenses and remove them as a disqualifying health plan. It would also add employer reporting and tweak HSA inflation indexing rules.

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  • Families and HSA holders: Would be able to pay direct primary care service arrangement fees with HSA funds. The law would cap aggregate fees at $150 per person per month, doubled if the arrangement covers more than one person.
  • Primary care practitioners: Establishes a clear definition of direct primary care service arrangements as fixed periodic fees for primary care only. It excludes certain services like procedures needing general anesthesia, prescription drugs other than vaccines, and some lab services and directs Treasury to issue guidance after consulting HHS.
  • Employers and employees: Requires employers to report aggregate employee direct primary care fees on Form W-2 when the arrangement is provided in connection with employment. The changes become effective for months beginning after December 31, 2025.
  • Tax rules and indexing: Adjusts the HSA inflation baseline to calendar year 2025 for indexation in taxable years after 2026.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 0 costs, 1 mixed.

HSA help for direct primary care fees

If enacted, you could keep HSA eligibility while using a direct primary care membership. You could use HSA money to pay these fees, up to $150 per month for one person, or $300 if the arrangement covers more than one person. Some services would not count, like procedures needing general anesthesia, most prescription drugs (except vaccines), and certain lab tests. The $150 cap would be indexed for inflation after 2026 using 2025 as the baseline. Treasury would issue guidance on how the exclusions apply. These rules would start for months beginning after December 31, 2025.

W-2 reporting of direct primary care fees

If enacted, employers would have to list the total direct primary care fees tied to your job on your Form W-2. This would apply only when the arrangement is provided in connection with employment. It would start for months beginning after December 31, 2025. This is a reporting rule and would not by itself change your taxes.

Sponsors & CoSponsors

Sponsor

Smucker, Lloyd [R-PA-11]

PA • R

Cosponsors

  • Rep. Tenney, Claudia [R-NY-24]

    NY • R

    Sponsored 2/5/2025

  • Rep. Schneider, Bradley Scott [D-IL-10]

    IL • D

    Sponsored 2/5/2025

  • Rep. Panetta, Jimmy [D-CA-19]

    CA • D

    Sponsored 2/5/2025

  • Rep. Crenshaw, Dan [R-TX-2]

    TX • R

    Sponsored 2/5/2025

  • Rep. Schrier, Kim [D-WA-8]

    WA • D

    Sponsored 2/5/2025

  • Rep. Kelly, Mike [R-PA-16]

    PA • R

    Sponsored 3/10/2025

  • Rep. LaHood, Darin [R-IL-16]

    IL • R

    Sponsored 3/11/2025

  • Rep. Onder, Robert F. [R-MO-3]

    MO • R

    Sponsored 3/14/2025

Roll Call Votes

No roll call votes available for this bill.

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