What You Need to Know About the Primary Care Enhancement Act?

Here are recent health care developments worth keeping tabs on: U.S. Senators Bill Cassidy, M.D. (R-LA), Jeanne Shaheen (D-NH), Tim Scott (R-SC), and Mark Kelly (D-AZ) are spearheading the Primary Care Enhancement Act.

Setting this bill in motion puts American health care – more importantly, patient-focused models such as Direct Primary Care (DPC) – in a more accessible, affordable position.

In this material, we dive into the Primary Care Enhancement Act – what it stands for and how it can positively affect patient access to primary care nationwide.

What is the Primary Care Enhancement Act?

The Primary Care Enhancement Act is a bipartisan bill that seeks to clarify outdated provisions related to Direct Primary Care in the U.S. Internal Revenue Code or the tax code.

The existing tax code states that patients eligible for a Health Savings Account (HSA) must adhere to the following conditions:

• Patient must have a High Deductible Health Plan (HDHP)
• They must not have another health plan that:
  • is not their HDHP
  • provides coverage for health benefits that are already under their HDHP

Until the IRS continues to identify Direct Primary Care as a form of insurance, Direct Primary Care patients are not eligible to contribute to a Health Savings Account. Consequently, HDHP-covered patients risk losing their Health Savings accounts if they are interested in using a DPC subscription.

Why Was The Primary Care Enhancement Act Created, To Begin With?

From a logical standpoint, the Primary Care Enhancement Act aims to correct certain technicalities within the tax code – specifically, Direct Primary Care being identified by law as other coverage or another form of insurance.

A lot is riding on the Primary Care Enhancement Act, given that the law treatment for Direct Primary Care is a major detractor behind employers securing DPC or Concierge Medicine subscriptions for their employees.

Direct Primary Care’s present law treatment also hinders patients who contribute to HSAs from receiving top-quality, individualized preventive care unique to membership-based models.

Accessible, affordable primary care has become an urgent matter for both government and private sectors. As a result, there has been a growing preference for membership-based models across the United States. That comes as no surprise considering that DPC and Concierge Medicine have consistent track records for providing convenient, above-and-beyond patient care.

As of 2021, membership-based practices have grown to 1,219 in over 48 states in America.

How does the Primary Care Enhancement Act affect the Direct Primary Care model?

Apart from clarifying that Direct Primary Care, by definition, is not a health plan or insurance, the Primary Care Enhancement Act also seeks to acknowledge Direct Primary Care as a qualified health expense.

The Primary Care Enhancement Act needs to be passed in Congress to gain support. HSA holders can now avail themselves of DPC subscriptions for themselves and their families.

Even better, the Primary Care Enhancement Act permits patients to use their Health Savings Account to cover DPC services, including virtual services and in-person visits.

The new bill also implies that patients subscribed to Direct Primary Care can now qualify for a Health Savings Account.

Here are other terms patients should take note of once the bill is passed:

• The Primary Care Enhancement Act applies only to affordable DPC agreements under $150 per month, per individual; $300 for family plans (indexed for inflation)
• Direct Primary Care services covered in the Primary Care Enhancement Act shall be limited to primary care and shall not include:
  • Procedures that require the use of general anesthesia
  • Laboratory services not typically administered in an ambulatory primary care setting
• These limitations are only applied to HSA holders

How Does The Primary Care Enhancement Act Help Patients?

Ultimately, the Primary Care Enhancement Act institutes better access to health care. Throughout the pandemic, lockdown restrictions and the virus threat have made the flexibility and convenience of Direct Primary Care all the more valuable.

Direct Primary Care delivers top-quality care in various settings – via teleconsultations, in the comforts of a patient’s home, and even beyond regular business hours. This has helped unburden medical facilities at a very crucial time, freeing up ER trips and hospital visits for acute, urgent cases.

With the Primary Care Enhancement Act in place, patients and employers finally have access to the priceless perks of a Direct Primary Care subscription – all without having to worry about choosing between DPC or their HSA.

A recent Milliman study reveals that DPC can reduce the total cost of care by up to 20% compared to a regular health plan. In addition, data from employers show that the ones who avail of DPC subscriptions for their employees have a greater return on their investment.

Virtual care, unlimited clinic visits, heavily discounted outpatient services, medication at wholesale cost, and more – membership-based practices, such as Direct Primary Care and Concierge Medicine, extend these services to patients with no additional or hidden charges.

The Primary Care Enhancement Act brings a democratic health care approach to over 23 million Americans. It seeks to give patients the freedom to make the best medical decisions for themselves and their loved ones.

Those reasons alone are enough for Direct Primary Care to get our vote of confidence. Do you think you would benefit from a DPC doctor? We have the most extensive collection of DPC doctors in US. Find your nearest DPC doctor in your area today at – findmydirectdoctor.com