Primary Care Enhancement Act of 2025
The impact of HB 1026 on state laws revolves around the treatment of healthcare service arrangements and the facilitation of access to primary care for individuals. By allowing direct primary care payments to count as eligible medical expenses for HSAs, the bill may empower consumers to engage more directly with primary care providers, potentially increasing competition and improving service delivery in healthcare. However, it may simultaneously present challenges for existing insurance frameworks and how they integrate with direct primary care arrangements.
House Bill 1026, known as the Primary Care Enhancement Act of 2025, seeks to amend the Internal Revenue Code of 1986 to recognize direct primary care service arrangements. The bill stipulates that such arrangements should not be classified as health plans for the purposes of maintaining eligibility for health savings accounts (HSAs). This amendment aims to encourage the use of direct primary care, which typically involves a monthly fee for primary care services without involving insurance, thereby providing an alternative model to traditional healthcare financing.
A potential point of contention involves the exclusions laid out in the bill concerning certain types of services within direct primary care arrangements, such as procedures requiring general anesthesia, prescription drugs, and laboratory services not commonly performed in an outpatient primary care setting. Critics may argue these exclusions could limit the comprehensiveness of care available under direct primary care. Additionally, there may be concerns about the implications of direct primary care on the overall healthcare system and whether it may inadvertently lead to disparities in access for those who cannot afford such arrangements.