Why can’t patients use their HSAs – supposedly their own money – to pay DPC fees? Because the IRS says they can’t. Not only that, if they have a DPC membership, they can’t even make a contribution to their HSA.
Congress was considering a simple bill to fix that – H.R. 365. But on the way to the House Ways and Means Committee, provisions were sneaked in, with very limited time to comment, and the bill number was changed to H.R. 6317. Some things from the Affordable Care Act (ACA) were inserted, along with provisions that independent DPC doctors said would favor huge corporate entities – purveyors of big-box medicine – that want to dominate the market. The government would micromanage what a DPC could or could not offer, based on the AMA’s copyrighted procedure codes, and cap the fee that the DPC could charge – not just the amount that could be paid from an HSA. It would allow only Direct Primary Care. It would not allow Direct Patient Care arrangements with specialists; for example, a direct-care agreement with an endocrinologist to manage diabetes would not qualify. Then the bill was incorporated into H.R. 6199, with some of the objectionable features removed, thanks to patients and doctors who spoke out. We’ll see what emerges from the sausage factory.
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