Direct Medical Care Freedom Act of 2025
Sponsored By: Representative Roy, Chip [R-TX-21]
Introduced
Summary
Preserve HSA eligibility for people in direct medical care service arrangements. The bill would carve fixed‑fee direct care contracts out of the tax code's "health plan" definition and add rules on who qualifies and how employers report fees.
Show full summary
- Individuals and families: People enrolled in a fixed periodic fee direct medical care arrangement would still be eligible to contribute to Health Savings Accounts. Fees paid under such arrangements would be treated as medical expenses for tax purposes.
- Employers and workers: If the arrangement is provided in connection with employment, employers would report the aggregate fees for that arrangement on employees' Form W-2.
- Providers and arrangements: The bill specifies qualifying practitioners as physicians, nurse practitioners, clinical nurse specialists, and physician assistants. It also allows arrangements that are limited to a subset of care or practitioners to qualify.
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Use your HSA with direct care
If enacted, you could keep HSA eligibility while using a qualifying direct medical care arrangement. You could also treat the arrangement’s fixed fees as medical expenses and pay or reimburse them from an HSA. The arrangement must provide care from physicians, nurse practitioners, clinical nurse specialists, or physician assistants, with payment only as a fixed periodic fee. Arrangements limited to certain services or practitioners could still qualify. These changes would start for months after December 31, 2024.
New W-2 reporting of direct care fees
Employers would have to list the total fees for any qualifying direct medical care arrangement on employees’ W-2 forms. This would apply when the arrangement is tied to the job and paid as a fixed periodic fee to covered clinicians. Reporting would start for months after December 31, 2024.
Sponsors & CoSponsors
Sponsor
Roy, Chip [R-TX-21]
TX • R
Cosponsors
Rep. Biggs, Andy [R-AZ-5]
AZ • R
Sponsored 2/7/2025
Rep. Moore, Barry [R-AL-1]
AL • R
Sponsored 2/7/2025
Rep. Harris, Andy [R-MD-1]
MD • R
Sponsored 2/27/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov