86R14371 KSM-D
By: Shaheen H.C.R. No. 90
CONCURRENT RESOLUTION
WHEREAS, An effective way to offset the increasing cost of
health care is to use direct primary care for all primary health
care services and use a high deductible health insurance plan in
combination with a health savings account to cover more expensive
care and hospitalization; and
WHEREAS, In direct primary care, a single low monthly fee to a
physician or clinic covers all primary care services, with no
preexisting condition exclusions, no disagreements over covered
treatments, no insurance forms to fill out, and no deductibles or
co-pays; and
WHEREAS, A high deductible health insurance plan in
combination with a health savings account is offered by the
Employees Retirement System (ERS) of Texas to state employees; the
ERS notes that health savings accounts are like tax-free nest eggs
for health care expenses because contributions are tax-free, up to
a certain amount set by the Internal Revenue Service; withdrawals
are not taxed, as long as the money is used for qualified health
expenses, and interest and investment earnings are not taxed; and
WHEREAS, Unfortunately, Texans who enroll in a high
deductible health insurance plan in combination with a health
savings account cannot use their health savings account to pay for
direct primary care because of an Internal Revenue Service ruling
that direct primary care constitutes a second health insurance
plan, which is prohibited under federal law governing tax-free
contributions to a health savings account; and
WHEREAS, Like many other states, Texas has passed legislation
to establish that direct primary care is not insurance and that a
physician providing direct primary care in return for a monthly
retainer is not subject to regulation by the Texas Department of
Insurance for the direct primary care; and
WHEREAS, Likewise, a federal regulation adopted by
the U.S. Department of Health and Human Services to implement the
Affordable Care Act treats direct primary care clinics, known as
medical homes, as a health benefit, not a health insurance plan; and
WHEREAS, Despite state and federal action to clarify that
direct primary care is not insurance, congressional action is
needed to allow health savings accounts to be used for direct
primary care; such action would benefit many Texans, including
those in rural communities, by encouraging more patients to get
their care from a personal physician, rather than a hospital
emergency room, and by encouraging more physicians to practice in
direct primary care; now, therefore, be it
RESOLVED, That the 86th Legislature of the State of Texas
hereby urge Congress to allow health savings accounts to be used for
direct primary care; and, be it further
RESOLVED, That the Texas secretary of state forward official
copies of this resolution to the president of the United States, to
the president of the Senate and the speaker of the House of
Representatives of the United States Congress, and to all the
members of the Texas delegation to Congress with the request that
this resolution be entered in the Congressional Record as a
memorial to the Congress of the United States of America.