In an exciting development for Direct Primary Care (DPC) advocates, two major pieces of bipartisan legislation are moving through Congress that could have significant impacts on the DPC model. These bills, H.R. 3029 (The Primary Care Enhancement Act) and H.R. 3836 (The Medicaid Primary Care Improvement Act), aim to expand access to DPC for both private and Medicaid-covered patients.

H.R. 3029: The Primary Care Enhancement Act

The Primary Care Enhancement Act, H.R. 3029, is a major breakthrough for patients with Health Savings Accounts (HSAs) and High-Deductible Health Plans (HDHPs). If passed, this bill would allow these individuals to participate in DPC arrangements while still being eligible to contribute to their HSAs—a major step forward for integrating DPC into mainstream healthcare.

This legislation, spearheaded by Sen. Bill Cassidy, MD (R-LA) and Rep. Earl Blumenauer (D-OR), has already made it through the House Ways and Means Committee as part of a larger bill (H.R. 5688) and is currently awaiting consideration by the full House of Representatives.

Why It Matters:

For years, patients with HSAs have faced barriers to enrolling in DPC plans because current IRS rules restrict how these accounts can be used with non-insurance healthcare models like DPC. If H.R. 3029 becomes law, millions of Americans could finally access DPC without having to choose between their HSA tax benefits and personalized, primary care.

H.R. 3836: The Medicaid Primary Care Improvement Act

Another critical bill on the horizon is H.R. 3836, known as The Medicaid Primary Care Improvement Act. This bill clarifies that Medicaid programs can offer direct primary care services to beneficiaries without needing a federal waiver from the Centers for Medicare & Medicaid Services (CMS). With Reps. Dan Crenshaw (R-TX) and Kim Schrier, MD (D-WA) leading the charge, the bill passed its committee with unanimous support (28-0) and now awaits further action in the House.

Why It Matters:

Currently, states wanting to implement DPC for Medicaid patients must navigate a complicated and lengthy waiver process through CMS. H.R. 3836 simplifies this by allowing Medicaid to work directly with DPC practices, paving the way for more states to adopt this model and give low-income patients access to more personalized, primary care.

A Bipartisan Push for DPC's Future

Both bills represent a significant bipartisan push to mainstream DPC and make it more accessible to various populations, from those with private insurance and HSAs to Medicaid beneficiaries. With growing support from both sides of the aisle, this legislation could help elevate DPC as a viable alternative to traditional healthcare models, offering patients more choice and better care.

For more details, check out the replay of our recent livestream below, where we broadcasted the DPCC Steering Committee Meeting live in Washington, DC. 

New to DPC? Check out our recent article, A Quick Guide to Direct Primary Care.