14. Department of Health and Human Services · Notable
Clarify that direct primary care fees are not insurance
Printed page 469 14. Department of Health and Human Services
“Remove barriers to direct primary care. … Changes should clarify that DPC’s fixed fee for care does not constitute insurance in the context of health savings accounts.”
What has happened
- Done
Public Law 119-21 § 71308 amends § 223 of the Internal Revenue Code so that a direct primary care service arrangement is not treated as a health plan for high-deductible health plan purposes and its periodic fee is a qualified medical expense payable from a health savings account, subject to a monthly fee cap. That is exactly the clarification the Quote asks for — the fixed subscription fee no longer counts as insurance in the HSA context — enacted rather than regulated, and in force.
Research log
What was searched, and what didn’t count as evidence
Research notes
- § 71308 was read at https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm. The House-passed version carried the identical provision as § 110205 of H.R. 1 (engrossed in House, 2025-05-22), and unlike the CHOICE-arrangement sections it survived the Senate.
- Federal Register search for “direct primary care” since 2025-01-20 → 0 documents: Treasury and IRS have published no implementing guidance yet, which does not affect the Status because the statute is self-executing on this point.
- Action
- other
- Object
- direct primary care classification under HSA rules
- ID
- 1288