Primary Care Enhancement Act of 2025

This bill amends the Internal Revenue Code to treat direct primary care service arrangements as medical care, allows them to not disqualify health savings account contributions, and requires reporting of fees on W-2 forms.

Sec. 2, Treatment of direct primary care service arrangements: This section adds direct primary care service arrangements to the list of expenses treated as medical care for tax purposes. It defines such arrangements as those providing primary care services from primary care practitioners for a fixed periodic fee, excluding procedures requiring general anesthesia and lab services not typically done in an ambulatory primary care setting. Only eligible fee amounts, capped at $150 per month per individual (or $300 if covering more than one person), indexed for inflation after 2026, count as medical care. It also clarifies that these arrangements are not treated as a health plan or insurance for health savings account rules, meaning they do not disqualify deductible HSA contributions. Employers must report aggregate fees for such arrangements on employees' W-2 forms. These changes apply to months beginning after December 31, 2025, in taxable years ending after that date.