What Does the Primary Care Enhancement Act Mean for Physicians?

When Congress introduces legislation with “primary care” in the title, it’s worth paying attention. The Primary Care Enhancement Act of 2025 (H.R. 1026) is one of those bills that may not make front-page headlines, but for physicians—especially those practicing in or considering Direct Primary Care (DPC)—it could change the playing field in important ways.

At its core, the Act addresses a technical but meaningful problem: the uneasy relationship between DPC arrangements and Health Savings Accounts (HSAs). Until now, patients who joined a DPC practice often found themselves locked out of using their HSAs—one of the most flexible, tax-advantaged ways to pay for healthcare. The bill would fix that, recognizing DPC as a medical service rather than insurance, and making monthly membership fees an eligible medical expense. That may sound like a small tweak, but it opens doors.

Why This Matters

For physicians, the implications go beyond tax code cleanup. This is about accessibility and growth. Many patients like the idea of direct care—predictable costs, a stronger relationship with their doctor, fewer administrative hoops. But when their HSA couldn’t be used to pay for it, adoption stalled. The Act effectively removes that barrier, making DPC a viable option for millions more people.

Think about what that could mean: a broader patient pool for DPC practices, greater financial stability for physicians, and—most importantly—more room to practice medicine the way it was intended: with time, presence, and trust at the center.

Opportunities and Questions

Of course, no legislation is perfect. The Act caps qualifying monthly DPC fees at $150 for individuals and $300 for families (bill text, Sec. 223). That may work well for some practices, but others will have to revisit pricing models to stay within those limits. For larger practices or those offering expanded services, this ceiling could feel restrictive.

There’s also the practical matter of transparency. Employers will be required to report DPC fees on employee W-2 forms. While this makes sense from a compliance perspective, it introduces new administrative tasks that both employers and physicians will need to navigate.

And let’s not forget the timeline: even if the bill passes quickly, most provisions don’t kick in until 2026. That means physicians have a window—time to adjust fee structures, educate patients, and prepare for new reporting requirements.

A Step Toward Smarter Primary Care

Viewed more broadly, the Primary Care Enhancement Act signals something bigger: a growing recognition in Washington that primary care deserves better support. It validates DPC as a legitimate, sustainable way to deliver care, not a fringe experiment. For physicians who’ve felt caught between a fee-for-service treadmill and insurer red tape, this is welcome news.

It’s not a silver bullet, and it won’t solve every challenge facing primary care. But it does clear one important barrier. And sometimes, that’s what change looks like—incremental steps that make it a little easier to do the work you trained for: caring for patients.

Where Physicians Go From Here

If you’re a DPC physician, this is the moment to start strategizing. How will you position your practice when patients can finally use their HSAs to cover membership fees? How will you communicate the value of this shift to your community?

If you’re not currently in DPC, the Act may spark a different question: does this lower the barrier enough to make direct care worth considering?

At Elation, we believe physicians should have the flexibility to practice in models that elevate care without compromising financial sustainability. The Primary Care Enhancement Act doesn’t solve everything, but it’s a push in the right direction—toward transparency, patient choice, and a stronger future for primary care.

Ready to optimize your practice under the new law? Explore how Elation supports DPC practices and learn how our tools can help you deliver more personalized, efficient care while navigating regulatory changes.