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Bliss, MD: Separating Fact from Fiction (Open Letter, HSAs; H.R. 3708)

“The good news is that after 10 years of hard policy work, there is now bipartisan support to change the law.” ~Bliss, MD; Oct 2019

AAFP encourages the Committee to approve H.R. 3708 and advance the bill to the next stages of the legislative process.

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.

READ: Markup of Republican Reconciliation Legislation | House Budget Committee Democrats

READ: An Open Letter to Congress from Garrison Bliss, MD, Chairman, Direct Primary Care  Coalition, Founder of the First DPC Practice

The Primary Care Enhancement Act: Separating Fact from Fiction (DPC Coalition, Open Letter)

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. 3708 mirrors 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.

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.”2

Following 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 8 different 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.

READ FULL DPC Coalition; Oct 2019 LETTER …

SOURCE: DPC Coalition; Oct 2019

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.

READ: Markup of Republican Reconciliation Legislation | House Budget Committee Democrats

H.R.3708 – Primary Care Enhancement Act of 2019 116th Congress (2019-2020) | Get alerts

The AAFP | John S. Cullen, MD, FAAFP, Board Chair | OCT 23, 2019

The AAFP has been a strong supporter of the DPC model for more than a decade and views it as a practice model that is consistent with our goals of expanding access to primary care for all Americans and is one of growing interest to our members. The Primary Care Enhancement Act (H.R. 3708) is aligned with current AAFP policy that supports changes to existing law to permit individuals holding a health savings account (HSA) to use those funds to pay the periodic payments associated with a DPC practice for a defined set of primary care services. For this reason, the AAFP encourages the Committee to approve H.R. 3708 and advance the bill to the next stages of the legislative process.

READ THE FULL AAFP OCTOBER 2019 LETTER HERE …

SOURCE: https://www.aafp.org/dam/AAFP/documents/advocacy/payment/dpc/LT-WM-DPCMarkup-102319.pdf

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