Cassidy, Shaheen, Scott, Kelly Reintroduce Bill to Allow HSAs to Be Used for Direct Primary Care

Published 5:30 am Friday, March 3, 2023

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WASHINGTON – U.S. Senators Bill Cassidy, M.D. (R-LA), Jeanne Shaheen (D-NH), Tim Scott (R-SC), and Mark Kelly (D-AZ) today introduced a bipartisan bill to support Direct Primary Care (DPC), lower health care costs, and expand patient access to their primary care providers. The Primary Care Enhancement Act increases access to affordable preventative and primary care by allowing health savings accounts (HSAs) to be used to pay for direct primary care. This enables patients to rely less on specialists and hospital referrals.


“With direct primary care, patients have control over their families’ health care decisions. That was the intent when creating health savings accounts,” said Dr. Cassidy. “This bill empowers patients to see the doctor they trust.”


“A strong relationship between a patient and their primary care provider is vital to keeping individuals healthy and health care costs down,” said Senator Shaheen. “I’m glad to join this bipartisan bill that would break down barriers that patients face when seeking care to allow health savings accounts to be used for direct primary providers. I’ll do everything I can to reform our health policies that best support patients and families.”


“Arizonans deserve access to the medical care they need with the provider they know, trust, and feel comfortable with. This bill will allow patients to get the care they need when they need it. This is the kind of commonsense change we have to push if we want to make our health system work better for families,” said Senator Kelly. 


The bill clarifies the tax code so that a DPC agreement does not make a patient ineligible to contribute to an HSA, and that pre-tax HSA funds may be used to pay DPC fees. 



DPC is a growing model used by thousands of practices in almost every state. With DPC, care is delivered in any setting, including using virtual care, telemedicine, and office visits beyond normal business hours. DPC reduces the burden on emergency rooms and clinics and encourages patients to develop personal relationships with their doctors.


DPC agreements replace copays and deductibles with flat, affordable monthly fees. Current tax law makes DPC incompatible with health savings account (HSA) plans because the IRS defines DPC as insurance. Over thirty states have passed laws and regulations to clarify that DPC is not insurance, but a medical service. The Affordable Care Act even recognizes DPC as an advanced payment model outside insurance.