S. 1719 — Primary Care Enhancement Act of 2025

This section establishes tax treatment for direct primary care service arrangements—defined as contracts under which an individual receives primary care services (i.e., routine care by primary care practitioners, excluding procedures requiring general anesthesia and certain laboratory services not typically provided in ambulatory primary care settings) solely in exchange for fixed periodic fees—as follows: (1) treats eligible fees as medical care for purposes of the medical expense deduction under IRC §213(d)(1), limited to $150 per month per individual ($300 if the arrangement covers more than one individual), with the $150 amount indexed for inflation after 2026; (2) excludes such arrangements from being treated as health plans or insurance for health savings account (HSA) eligibility under IRC §223; and (3) requires employers to report aggregate fees for employment-related arrangements on employees' Form W-2s under IRC §6051(a). The changes apply to months beginning after December 31, 2025.