Direct Primary Care and HSA Clarification May Get Done Soon
Okay, settle down, folks. Let’s unpack this a bit. Right off the bat, I will say that even though this is a “political” post, I am not going to let comments fall into an ideological fight. DPC News exists to promote Direct Primary Care and what RFK Jr. is explaining is Direct Primary Care and not Concierge Care. If you’re unsure of the difference, read this link.
First, I have spoken to some very connected DPC docs who helped “educate” the administration about Direct Primary Care for this bill. No, the government won’t be paying the $75. This bill will clarify, once and for all, that the monthly payment to DPC doctors is tax-deductible. Yes, many of your patients have already been doing this, but the big businesses have been too afraid to jump in. Now they will.
Why is this good? Anything that promotes DPC is good in my opinion, and, as you can see from RFK Jr.’s interview, it looks like there will be a hard push to promote Direct Primary Care if this passes. This may be the tipping point needed to get patients as well as other doctors, residents, and medical students to make the jump. Awesome.
Why is this bad? Well, any time the government gest involved with something they tend to screw it up. Who knows how they will put their stamp on DPC with regulations, etc.? Also, this really could give the VCs and Private Equity firms the motivation they need to truly open the spigot for bastardizing the concept of Direct Primary Care.
I am just reporting the news. I welcome all comments unless they get nasty and political. Do that on your own social media sites if you want.
Exciting and dangerous territory Doug, as you say with both Private Equity and Government. We definitely will need an excellent legal team on our side.
What is with the $75? Many of us charge more than that now.
I am not sure but I think the next debate is the cap which is $150. Maybe the $75 came from my book and my original prices?
The cap in the bill, as it presently stands, is $150. The $75 mentioned by Sec’y Kennedy was probably from a briefing he was given which included a mention of a “typical” plan.
More significant than language making “below-the-line” (Schedule A) tax deductibility a clear statutory mandate, in my view, the bill’s also allows DPC patients to contribute to in tax-favored Health Savings Accounts (HSAs). Among other features, contributions to HSA are more impactful “above-the-line” deductions; they reduce adjusted gross income even for those who do not itemize deductions.
But participation in HSAs requires membership in qualified high-deductible health insurance plans. Health share membership do not qualify, at least at present.
If this portion of the bill gets enacted, the next battle would likely be whether, or under what conditions, conventional insurers will credit the monthly DPC fees toward fulfillment of insurance deductibles and insurance out-of-pocket maximums. Some insurers might resist crediting DPC fees at all. While government might plausibly come down on either side of the issue in principle, I think it likely that insurers will still be able to set standards for participation in their own “networks”. In any case, there will likely be some potential government and/or insurer leverage at the point this issue is reached.
Thank you for this info.