# Plain Language Summary: Direct Medical Care Freedom Act of 2025

This bill makes it easier for people to use Health Savings Accounts (HSAs) while also paying for direct primary care arrangements. Here's what that means in practical terms: Some people pay a doctor a flat monthly or yearly fee to be their primary care provider, similar to a membership. Right now, if you have this kind of arrangement, you're technically not allowed to use an HSA—a special tax-advantaged savings account designed for medical expenses. This bill removes that restriction, so you can do both at the same time.

The bill defines what counts as a direct medical care arrangement: it's when you pay a fixed periodic fee (like $50 a month) directly to a doctor, nurse practitioner, clinical nurse specialist, or physician assistant for their services. The key is that the doctor's only payment for treating you is that flat fee—they're not billing insurance or charging per visit. The arrangement can be limited to just primary care or can include specialty care; the bill is flexible about what types of medical services are included.

Under this bill, the fees you pay for these direct care arrangements would be treated as eligible medical expenses that you can pay for with your HSA money. Additionally, if your employer provides this arrangement as an employee benefit, they would need to report the total fees on your W-2 form. This gives the IRS visibility into how much you're paying for direct care. The changes take effect for months beginning after December 31, 2024, meaning they apply starting in 2025.