The second provision solves a somewhat arcane HSA problem for individuals and families that have a special arrangement with their primary care doctor, known as a “direct primary care” arrangement.  Under these arrangements, people pay their doctor a monthly (or annual) fee instead of paying their doctor only when they are seen in person.  Today, DPC arrangements disqualify Americans from contributing to an HSA because the arrangements are incompatible with the current rules for eligibility to contribute to an HSA.  No longer, starting January 1, 2026.

By HSA Consulting Services; July 2025

To be sure, only three provisions passed the Congress today rather than ten provisions which passed the House six weeks ago.  Such is the “sausage making” process of writing laws.  However, the three provisions that did pass should have a big impact on millions more Americans and on how health care is financed in this country.  Here is a quick summary of these provisions.

RELATED INSIGHTS | PODCAST | JULY 2025 (LISTEN TO LATEST EPISODE ON THIS TOPIC)
Summary Opinions and First Glance POVs Note: “The law places a limit on DPC membership fees at $150 per month for individuals (or $300 for families). While this cap makes DPC more financially accessible to a broader audience, it also restricts providers’ ability to charge for more comprehensive services that could reflect the quality and availability of care. This limit may dissuade some quality DPC practices from expanding their offerings, potentially leading to a lack of diversity in services; The law defines DPC coverage strictly as primary care services delivered by a primary care provider. However, services requiring general anesthesia, prescription medications (other than vaccines), and certain lab tests don’t fall within this coverage. This limitation might lead to confusion and dissatisfaction among patients who expect a more comprehensive level of care.” (Latest Episode on this topic)

“Only a small percentage of Health Savings Account owners will take advantage of this opportunity initially, but the number may grow in the future when HSA-qualified plan enrollees realize how cost certainty for primary care, a focus on maintaining health, and assistance in navigating other care based on price and quality dovetail with their financial and medical goals.” ~B. Stuart, July 2025

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SOURCE: HSA Consulting Services; July 2025; https://hsaconsultingservices.com/newsletter/a-big-beautiful-hsa-expansion