119-s1719

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1719 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 1719

To amend the Internal Revenue Code of 1986 to provide for the treatment 
of direct primary care service arrangements as medical care, to provide 
 that such arrangements do not disqualify deductible health savings 
 account contributions, and for other purposes.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 May 12, 2025

 Mr. Cassidy (for himself, Mrs. Shaheen, Mr. Scott of South Carolina, 
 Mr. Kelly, and Mr. Lankford) introduced the following bill; which was 
 read twice and referred to the Committee on Finance

_______________________________________________________________________

 A BILL

To amend the Internal Revenue Code of 1986 to provide for the treatment 
of direct primary care service arrangements as medical care, to provide 
 that such arrangements do not disqualify deductible health savings 
 account contributions, 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) Amount Treated as Medical Care.--

    (1) In general.--

Section 213
            (d) (1) of the Internal Revenue 
 Code of 1986 is amended by striking ``or'' at the end of 
 subparagraph
            (C) , by striking the period at the end of 
 subparagraph
            (D) and inserting ``, or'', and by inserting after 
 subparagraph
            (D) the following new subparagraph:
 ``
        (E) for direct primary care service 
 arrangements.''.

    (2) Limitation.--

Section 213
            (d) (1) of such Code, as amended 
 by paragraph

    (1) , is further amended by adding at the end the 
 following: ``In the case of a direct care primary service 
 arrangement, only eligible fee amounts (as defined in paragraph

    (13) ) shall be taken into account under subparagraph
        (E) .''.

    (3) === Definitions. ===
-

Section 213
            (d) of such Code is amended by 
 inserting after paragraph

    (11) the following new paragraphs:
 ``

    (12) Direct primary care service arrangement.--
 ``
        (A) 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 paragraph

    (1) , 
 determined without regard to subparagraph
        (E) thereof) 
 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.
 ``
        (B) 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, and
 ``
            (ii) 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 
 subparagraph.
 ``

    (13) Eligible fee amount.--
 ``
        (A) In general.--The term `eligible fee amount' 
 means, with respect to any individual for any month, 
 the amount of fixed periodic fees paid for a direct 
 care primary service arrangement, to the extent that 
 the aggregate fees for all direct primary care service 
 arrangements with respect to such individual for such 
 month do not exceed $150 (twice such dollar amount in 
 the case of an individual with any direct primary care 
 service arrangement that covers more than one 
 individual).
 ``
        (B) Indexing.--In the case of any taxable year 
 beginning in a calendar year after 2026, the $150 
 amount contained in subparagraph
        (A) shall be increased 
 by an amount equal to--
 ``
            (i) such dollar amount, multiplied by
 ``
            (ii) the cost-of-living adjustment 
 determined under 

section 1

    (f)

    (3) for the 
 calendar year in which such taxable year begins 
 determined by substituting `calendar year 2025' 
 for `calendar year 2016' in subparagraph
        (A)
            (ii) thereof.
 If any increase under the preceding sentence is not a 
 multiple of $10, such increase shall be rounded to the 
 nearest multiple of $10.''.

    (b) Health Savings Accounts.--

Section 223
            (c) of the Internal 
Revenue Code of 1986 is amended by adding at the end the following new 
paragraph:
 ``

    (6) Treatment of direct primary care service 
 arrangements.--A direct care primary service arrangement (as 
 defined in 

section 213
            (d) (12) )--
 ``
        (A) shall not be treated as a health plan for 
 purposes of paragraph

    (1)
        (A)
            (ii) , and
 ``
        (B) shall not be treated as insurance for 
 purposes of subsection
            (d) (2)
        (B) .''.
            (c) Reporting of Direct Primary Care Service Arrangement Fees on W-
2.--

Section 6051

    (a) of the Internal Revenue Code of 1986 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 213
            (d) (12) ) which is 
 provided in connection with employment, the aggregate fees for 
 such arrangement for such employee.''.
            (d) 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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