Primary Care Enhancement Act of 2025

This bill allows individuals with direct primary care service arrangements to remain eligible for health savings accounts (HSAs) by treating such arrangements as not being health plans, and treats fees for these arrangements as medical expenses. It also provides for inflation adjustments and reporting requirements.

Sec. 2, Treatment of direct primary care service arrangements: This section amends the Internal Revenue Code to specify that a direct primary care service arrangement is not considered a health plan for HSA eligibility purposes. A direct primary care service arrangement is defined as an arrangement where an individual receives primary care services from primary care practitioners for a fixed periodic fee, with a monthly fee limit of $150 (or $300 if covering more than one individual). Primary care services exclude procedures requiring general anesthesia, prescription drugs (except vaccines), and lab services not typically administered in an ambulatory primary care setting.

Sec. 2(b), Direct primary care service arrangement fees treated as medical expenses: Fees for direct primary care service arrangements are added to the list of medical expenses that can be paid from an HSA.

Sec. 2(c), Inflation adjustment: The $150 fee limit will be adjusted for inflation starting in 2027, using 2025 as the base year.

Sec. 2(d), Reporting of direct primary care service arrangement fees on W-2: Employers must report the aggregate fees for direct primary care service arrangements provided to employees on their W-2 forms.

Sec. 2(e), Effective date: These changes apply to months beginning after December 31, 2025, in taxable years ending after that date.