On October 23, 2019, the House Committee on Ways and Means held a markup of four tax and health bills. Legislation included: H.R. 4742, the Protecting American Lungs Act of 2019; H.R. 4716, the Inhaler Coverage and Access Now (I CAN) Act; H.R. 1922, the Restoring Access to Medication Act of 2019; and H.R. 3708, the Primary Care Enhancement Act of 2019.
The Primary Care Enhancement Act: Separating Fact from Fiction
A Bipartisan Direct Primary Care Bill advanced from the House Ways and Means Committee on October 23, 2019in a rare unanimous vote. H.R. 3708, The Primary Care Enhancement Act,provides important clarifications to the tax code that will allow DPC agreements to be fully compatible with High Deductible Health Plans paired with Health Savings Accounts (HSAs). The legislation, which the Joint Committee on Taxation(JCT) estimates will come with a cost to the Treasury of roughly $1.8 billion over ten years is accompanied by the first ever tax on nicotine vape products which would offset the cost of the DPC legislation. This is a unique bipartisan action in an unusually partisan time and we applaud Congress for taking this important step to move the bill and improve public health. H.R. 3708mirrors the legislation passed by the House last year—H.R. 6199 (115th). The White House issued a Statement of Administration Policy1and supported the bill along with major medical societies and employer groups. This bill has long been a priority for the growing number of patients with HSA compatible HDHPs and DPC physicians. Now, these pioneering doctors and their patients are joined by a nationwide coalition of thousands of employers, unions, brokers,and advisors who see this as a critical choice for the lives they cover that would be improved by receiving relationship-based care from a personal primary care physician of their choice—at an AFFORDABLE monthly fee.The Problem. Under current tax law, to be eligible to fund an HSA, individuals must be covered by a “high deductible health plan and no other health plan that (1) is not a high deductible health plan and (2) provides coverage for any benefit which is covered(e.g. primary care)under the high deductible health plan.”2Following current law,(26 U.S. Code § 223)on Health Savings Accounts, IRS interprets DPC plans as health plans which provide primary care, which is in fact a covered benefit in all HDHPs. Sadly, some physicians not familiar with the law or legislative language have misinformed patients and other providers that this is not the case… saying that patients with HSAs have been using DPC for over a decade. However, the Treasury Department, IRS, and Congress clearly disagree. There are at least 8different pending bills with language to correct the HSA definition in the current session alone. If the problem didn’t exist, neither would these bills. The good news is that after 10 years of hard policy work, there is now bipartisan support to change the law.
SOURCE: DPC Coalition; Oct 2019