The House of Representatives passed H.R. 6199 Wednesday, intended to help patients take advantage of the new movement toward affordable, accessible, personalized primary care called DPC for Direct Primary Care.
A monthly membership fee often less than $100 gives patients quick access to their personal physician of choice, including many tests and procedures. Some practices even dispense generic prescription drugs at a tiny fraction of the price at a retail pharmacy.
Patients get telephone consults, same-day appointments, after-hours care, sometimes even home visits from an independent physician who knows them and is working to meet their needs rather than helping the bottom line of a managed-care monolith.
Section 3 of the bill would allow patients to use funds from their Health Savings Account (HSA) to pay their membership fees. This is supposed to be their own money—but misguided IRS rules not only forbid this use of HSA money, but won’t allow contributions to an HSA if a person is a member of a DPC practice.
Independent DPC practice—unlike various government reform projects—actually does decrease costs, prevent emergency visits, and preserve quality.
Thankfully, prior to passage, the House removed a bad provision in the bill limiting DPC arrangements to specific CPT codes. We hope the United States Senate will act quickly and will fix some remaining problems in the bill that tend to limit patient choice.
AAPS strongly urges the Senate to make revisions to HR 6199 to explicitly define DPC as medical care (instead of a plan) so patients can use their HRAs and FSAs for this care and to avoid any conflict with state laws protecting DPC; lift caps that ration the amount of care obtained through HSA-eligible DPC arrangements; and remove the constraints on specialty care.
The United States Senate and President Trump have a tremendous opportunity to empower patients and independent physicians, while strengthening choice, competition, and increasing access to high quality care at an affordable cost.
- Suggestions for changes to improve H.R. 6199: http://bit.ly/fix6199
- Text of H.R. 6199 as passed by House: http://docs.house.gov/billsthisweek/20180723/BILLS-115HR6199HR6301HR6305HR6312HR6317-RCP115-82.pdf
- Oped: Congress and the IRS Have Stranded Patients in SwampCare: https://www.investors.com/politics/commentary/direct-primary-care-dpc-tax-code/
Call or write your Senators. You can quickly reach your Senators’ offices by calling the Capitol Switchboard at (202) 224-3121.Calling is the fastest way to make the biggest impact. While the House will be in recess until Labor Day, Majority Leader McConnell is keeping the Senate in DC, except for the week of Aug. 6.
A list of email addresses for each Senator’s health staff member can be found here: https://goo.gl/RP8Nk5
You can also send an e-message to your Senators using the links available here: https://www.senate.gov/general/contact_information/senators_cfm.cfm
Here is a suggestion of what you might say:
I am a constituent writing to ask you to support patient-friendly changes to Sec. 3 of H.R. 6199. The intention of this measure is to allow the use of Health Savings Accounts (HSAs) for Direct Primary Care (DPC). A few changes will give patients more vitally needed control over their medical spending. The requested improvements include: 1) explicitly define DPC as medical care (instead of a plan) so patients can use their HRAs and FSAs for this care and to avoid any conflict with state laws protecting DPC; 2) lift caps that ration the amount of care obtained through HSA-eligible DPC arrangements; and 3) remove constraints that impede patient arrangements with specialists. For more specifics, please see http://bit.ly/fix6199.
Thank you for your consideration,
If you are a patient or would like to give your patients instructions for speaking out and a draft letter, please see: http://bit.ly/patientdpcletter