Big changes are on the horizon for Direct Primary Care (DPC).
In Oregon, HB 2540 (effective January 1, 2026) will make it easier for patients to integrate DPC with traditional insurance. Many DPC membership fees may now count toward a patient’s insurance deductible — a long-awaited step toward bridging the gap between conventional and membership-based care.
Meanwhile, at the federal level, the Primary Care Enhancement Act (H.R. 1026) would allow individuals to pay DPC fees with Health Savings Accounts (HSAs). This recognizes DPC as a qualified medical expense, helping patients and employers alike reduce financial friction and administrative complexity.
Together, these shifts signal a powerful trend: DPC is moving from the margins to the mainstream.
At the same time, the federal Primary Care Enhancement Act (H.R. 1026) would allow DPC fees to be paid with HSAs, treating DPC as a medical service rather than insurance. This shift promises to reduce financial friction, making high-quality, relationship-based care more attainable for anyone.
More details:
What Oregon HB 2540 Means (Effective January 1, 2026)
Under this new law, most Oregon health insurers will need to count certain out-of-pocket payments — such as DPC membership fees — toward an enrollee’s deductible and annual out-of-pocket maximum.
This applies even if the DPC provider is out-of-network, as long as:
- the care is medically necessary,
- the service is covered by the plan, and
- the DPC fee is less than what the same service would cost in-network.
Primary Care Enhancement Act of 2025 (H.R. 1026)
This proposed federal law would allow individuals with DPC arrangements to stay eligible for HSAs — and use those funds to pay for DPC memberships. Qualifying memberships would be capped at $150/month for individuals or $300/month for families.
If passed, this law would make DPC even more accessible to employers seeking affordable, high-quality primary care solutions for their teams.
Why this matters for Clinics and Employers
For clinics, this is an opportunity to grow your DPC model within a changing policy landscape that increasingly supports it. As insurance barriers fall away, DPC practices can reach more patients while maintaining the freedom and integrity that make this model thrive.
For employers, it means better options for employee health: predictable costs, fewer sick days, and a stronger connection between patients and providers. Pairing DPC with a high-deductible plan or HSA can deliver comprehensive care without the administrative bloat or inflated costs of traditional insurance.
Vital Edge Health is helping DPC clinics and employers work together to create sustainable, high-value care ecosystems that truly serve people — not systems. Let’s shape our future of healthcare together!
