119-hr1026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1026 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 1026

 To amend the Internal Revenue Code of 1986 to allow individuals with 
direct primary care service arrangements to remain eligible individuals 
 for purposes of health savings accounts, and for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 February 5, 2025

 Mr. Smucker (for himself, Ms. Tenney, Mr. Schneider, Mr. Panetta, Mr. 
 Crenshaw, and Ms. Schrier) introduced the following bill; which was 
 referred to the Committee on Ways and Means

_______________________________________________________________________

 A BILL

 To amend the Internal Revenue Code of 1986 to allow individuals with 
direct primary care service arrangements to remain eligible individuals 
 for purposes of health savings accounts, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Primary Care Enhancement Act of 
2025''.

SEC. 2. TREATMENT OF DIRECT PRIMARY CARE SERVICE ARRANGEMENTS.

    (a) In General.--

Section 223
            (c) (1) of the Internal Revenue Code of 
1986 is amended by adding at the end the following new subparagraph:
 ``
        (E) Treatment of direct primary care service 
 arrangements.--
 ``
            (i) In general.--A direct primary care 
 service arrangement shall not be treated as a 
 health plan for purposes of subparagraph
        (A)
            (ii) .
 ``
            (ii) Direct primary care service 
 arrangement.--For purposes of this paragraph--
 ``
            (I) In general.--The term `direct 
 primary care service arrangement' 
 means, with respect to any individual, 
 an arrangement under which such 
 individual is provided medical care (as 
 defined in 

section 213
            (d) ) consisting 
 solely of primary care services 
 provided by primary care practitioners 
 (as defined in 

section 1833
            (x) (2)
        (A) of 
 the Social Security Act, determined 
 without regard to clause
            (ii) thereof), 
 if the sole compensation for such care 
 is a fixed periodic fee.
 ``
            (II) Limitation.--With respect to 
 any individual for any month, such term 
 shall not include any arrangement if 
 the aggregate fees for all direct 
 primary care service arrangements 
 (determined without regard to this 
 subclause) with respect to such 
 individual for such month exceed $150 
 (twice such dollar amount in the case 
 of an individual with any direct 
 primary care service arrangement (as so 
 determined) that covers more than one 
 individual).
 ``
            (iii) Certain services specifically 
 excluded from treatment as primary care 
 services.--For purposes of this paragraph, the 
 term `primary care services' shall not 
 include--
 ``
            (I) procedures that require the 
 use of general anesthesia,
 ``
            (II) prescription drugs (other 
 than vaccines), and
 ``
            (III) laboratory services not 
 typically administered in an ambulatory 
 primary care setting.
 The Secretary, after consultation with the 
 Secretary of Health and Human Services, shall 
 issue regulations or other guidance regarding 
 the application of this clause.''.

    (b) Direct Primary Care Service Arrangement Fees Treated as Medical 
Expenses.--

Section 223
            (d) (2)
            (C) of such Code is amended by striking 
``or'' at the end of clause
            (iii) , by striking the period at the end of 
clause
            (iv) and inserting ``, or'', and by adding at the end the 
following new clause:
 ``
            (v) any direct primary care service 
 arrangement.''.
            (c) Inflation Adjustment.--

Section 223

    (g)

    (1) of such Code is 
amended--

    (1) by inserting ``,
            (c) (1)
            (D) 
            (ii) 
            (II) ,'' after ``

    (b)

    (2) '' 
 each place it appears, and

    (2) in subparagraph
        (B) , by inserting ``and
            (iii) '' after 
 ``clause
            (ii) '' in clause
            (i) , by striking ``and'' at the end 
 of clause
            (i) , by striking the period at the end of clause
            (ii) and inserting ``, and'', and by inserting after clause
            (ii) the 
 following new clause:
 ``
            (iii) in the case of the dollar amount in 
 subsection
            (c) (1)
            (D) 
            (ii) 
            (II) for taxable years 
 beginning in calendar years after 2026, 
 `calendar year 2025'.''.
            (d) Reporting of Direct Primary Care Service Arrangement Fees on W-
2.--

Section 6051

    (a) of such Code is amended by striking ``and'' at the 
end of paragraph

    (16) , by striking the period at the end of paragraph

    (17) and inserting ``, and'', and by inserting after paragraph

    (17) the 
following new paragraph:
 ``

    (18) in the case of a direct primary care service 
 arrangement (as defined in 

section 223
            (c) (1)
            (D) 
            (ii) ) which is 
 provided in connection with employment, the aggregate fees for 
 such arrangement for such employee.''.

    (e) Effective Date.--The amendments made by this section shall 
apply to months beginning after December 31, 2025, in taxable years 
ending after such date.
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