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119-s-1719119th CongressWALLET

Primary Care Enhancement Act of 2025

Sponsored By: Senator Cassidy, Bill [R-LA]

Introduced

Summary

Treat direct primary care service arrangements as tax-eligible medical care. This bill would let fixed periodic fees paid for direct primary care count as medical expenses for the tax deduction, clarify that those arrangements are not treated as health insurance for Health Savings Account rules, and require employers to report the fees on W-2s.

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  • Families and individuals: Eligible monthly fees for a direct primary care service arrangement would count toward the medical expense deduction but are capped at $150 per person per month. The cap is $300 per month for an arrangement that covers multiple people and is indexed for inflation after 2026. Certain services are excluded from counting, including procedures requiring general anesthesia and some lab services, with Treasury and HHS able to issue guidance on the exclusions.
  • People with Health Savings Accounts and taxpayers: The bill would specify that direct primary care arrangements are not treated as a health plan or as insurance for tax purposes so HSA contribution eligibility is preserved while allowing the deduction treatment.
  • Employers and workers: Employers would be required to report the aggregate direct primary care fees provided in connection with employment on employees' W-2 forms.

This approach would apply to months beginning after December 31, 2025, for taxable years ending after that date.

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Bill Overview

Analyzed Economic Effects

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

Tax deduction for primary care fees

This bill would let you count some direct primary care subscription fees as medical expenses for the tax deduction. You could count up to $150 per person each month, or $300 for an arrangement that covers more than one person. The $150 monthly cap would be indexed after 2026 and rounded to the nearest $10. The bill would also define what counts as a direct primary care arrangement and exclude certain major procedures and some lab tests. It would say a direct primary care arrangement is not a health plan for HSA rules, so such coverage alone would not let you qualify for HSA contributions. These rules would apply to months beginning after December 31, 2025.

W-2 reporting for primary care

This bill would require employers to report the total direct primary care arrangement fees provided in connection with employment on the employee's Form W-2. The reported amount would be the aggregate fees for the arrangement for the employee. The reporting rule would apply to months beginning after December 31, 2025.

Sponsors & CoSponsors

Sponsor

Cassidy, Bill [R-LA]

LA • R

Cosponsors

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 5/12/2025

  • Sen. Scott, Tim [R-SC]

    SC • R

    Sponsored 5/12/2025

  • Sen. Kelly, Mark [D-AZ]

    AZ • D

    Sponsored 5/12/2025

  • Sen. Lankford, James [R-OK]

    OK • R

    Sponsored 5/12/2025

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
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