Us Congress 2025-2026 Regular Session

Us Congress House Bill HB1026 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 1026
5	5	To amend the Internal Revenue Code of 1986 to allow individuals with
6	6	direct primary care service arrangements to remain eligible individuals
7	7	for purposes of health savings accounts, and for other purposes.
8	8	IN THE HOUSE OF REPRESENTATIVES
9	9	FEBRUARY5, 2025
10	10	Mr. S
11	11	MUCKER(for himself, Ms. TENNEY, Mr. SCHNEIDER, Mr. PANETTA, Mr.
12	12	C
13	13	RENSHAW, and Ms. SCHRIER) introduced the following bill; which was
14	14	referred to the Committee on Ways and Means
15	15	A BILL
16	16	To amend the Internal Revenue Code of 1986 to allow indi-
17	17	viduals with direct primary care service arrangements
18	18	to remain eligible individuals for purposes of health sav-
19	19	ings accounts, and for other purposes.
20	20	Be it enacted by the Senate and House of Representa-1
21	21	tives of the United States of America in Congress assembled, 2
22	22	SECTION 1. SHORT TITLE. 3
23	23	This Act may be cited as the ‘‘Primary Care En-4
24	24	hancement Act of 2025’’. 5
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27	27	•HR 1026 IH
28	28	SEC. 2. TREATMENT OF DIRECT PRIMARY CARE SERVICE 1
29	29	ARRANGEMENTS. 2
30	30	(a) I
31	31	NGENERAL.—Section 223(c)(1) of the Internal 3
32	32	Revenue Code of 1986 is amended by adding at the end 4
33	33	the following new subparagraph: 5
34	34	‘‘(E) T
35	35	REATMENT OF DIRECT PRIMARY 6
36	36	CARE SERVICE ARRANGEMENTS .— 7
37	37	‘‘(i) I
38	38	N GENERAL.—A direct primary 8
39	39	care service arrangement shall not be 9
40	40	treated as a health plan for purposes of 10
41	41	subparagraph (A)(ii). 11
42	42	‘‘(ii) D
43	43	IRECT PRIMARY CARE SERVICE 12
44	44	ARRANGEMENT.—For purposes of this 13
45	45	paragraph— 14
46	46	‘‘(I) I
47	47	N GENERAL.—The term ‘di-15
48	48	rect primary care service arrange-16
49	49	ment’ means, with respect to any indi-17
50	50	vidual, an arrangement under which 18
51	51	such individual is provided medical 19
52	52	care (as defined in section 213(d)) 20
53	53	consisting solely of primary care serv-21
54	54	ices provided by primary care practi-22
55	55	tioners (as defined in section 23
56	56	1833(x)(2)(A) of the Social Security 24
57	57	Act, determined without regard to 25
58	58	clause (ii) thereof), if the sole com-26
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61	61	•HR 1026 IH
62	62	pensation for such care is a fixed peri-1
63	63	odic fee. 2
64	64	‘‘(II) L
65	65	IMITATION.—With respect 3
66	66	to any individual for any month, such 4
67	67	term shall not include any arrange-5
68	68	ment if the aggregate fees for all di-6
69	69	rect primary care service arrange-7
70	70	ments (determined without regard to 8
71	71	this subclause) with respect to such 9
72	72	individual for such month exceed 10
73	73	$150 (twice such dollar amount in the 11
74	74	case of an individual with any direct 12
75	75	primary care service arrangement (as 13
76	76	so determined) that covers more than 14
77	77	one individual). 15
78	78	‘‘(iii) C
79	79	ERTAIN SERVICES SPECIFI -16
80	80	CALLY EXCLUDED FROM TREATMENT AS 17
81	81	PRIMARY CARE SERVICES .—For purposes 18
82	82	of this paragraph, the term ‘primary care 19
83	83	services’ shall not include— 20
84	84	‘‘(I) procedures that require the 21
85	85	use of general anesthesia, 22
86	86	‘‘(II) prescription drugs (other 23
87	87	than vaccines), and 24
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90	90	•HR 1026 IH
91	91	‘‘(III) laboratory services not 1
92	92	typically administered in an ambula-2
93	93	tory primary care setting. 3
94	94	The Secretary, after consultation with the 4
95	95	Secretary of Health and Human Services, 5
96	96	shall issue regulations or other guidance 6
97	97	regarding the application of this clause.’’. 7
98	98	(b) D
99	99	IRECTPRIMARYCARESERVICEARRANGEMENT 8
100	100	F
101	101	EESTREATED AS MEDICALEXPENSES.—Section 9
102	102	223(d)(2)(C) of such Code is amended by striking ‘‘or’’ 10
103	103	at the end of clause (iii), by striking the period at the 11
104	104	end of clause (iv) and inserting ‘‘, or’’, and by adding at 12
105	105	the end the following new clause: 13
106	106	‘‘(v) any direct primary care service 14
107	107	arrangement.’’. 15
108	108	(c) I
109	109	NFLATIONADJUSTMENT.—Section 223(g)(1) of 16
110	110	such Code is amended— 17
111	111	(1) by inserting ‘‘, (c)(1)(D)(ii)(II),’’ after 18
112	112	‘‘(b)(2)’’ each place it appears, and 19
113	113	(2) in subparagraph (B), by inserting ‘‘and 20
114	114	(iii)’’ after ‘‘clause (ii)’’ in clause (i), by striking 21
115	115	‘‘and’’ at the end of clause (i), by striking the period 22
116	116	at the end of clause (ii) and inserting ‘‘, and’’, and 23
117	117	by inserting after clause (ii) the following new 24
118	118	clause: 25
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121	121	•HR 1026 IH
122	122	‘‘(iii) in the case of the dollar amount 1
123	123	in subsection (c)(1)(D)(ii)(II) for taxable 2
124	124	years beginning in calendar years after 3
125	125	2026, ‘calendar year 2025’.’’. 4
126	126	(d) R
127	127	EPORTING OFDIRECTPRIMARYCARESERVICE 5
128	128	A
129	129	RRANGEMENT FEES ONW–2.—Section 6051(a) of such 6
130	130	Code is amended by striking ‘‘and’’ at the end of para-7
131	131	graph (16), by striking the period at the end of paragraph 8
132	132	(17) and inserting ‘‘, and’’, and by inserting after para-9
133	133	graph (17) the following new paragraph: 10
134	134	‘‘(18) in the case of a direct primary care serv-11
135	135	ice arrangement (as defined in section 12
136	136	223(c)(1)(D)(ii)) which is provided in connection 13
137	137	with employment, the aggregate fees for such ar-14
138	138	rangement for such employee.’’. 15
139	139	(e) E
140	140	FFECTIVEDATE.—The amendments made by 16
141	141	this section shall apply to months beginning after Decem-17
142	142	ber 31, 2025, in taxable years ending after such date. 18
143	143	Æ
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