Primary Care Enhancement Act Becomes Law: A Win for Families, Employers, Employees, and Long-Term Health

Written By Adama Diarra, DO, FACP

By Adama Diarra, DO, FACP

Portland, OR — August 11, 2025 — The recently enacted Primary Care Enhancement Act (PCEA) is poised to transform how Americans access primary care and how employers structure health benefits. Amid all the headlines surrounding the “One Big Beautiful Bill,” a small but powerful provision received little public attention when it was signed into law on July 4, 2025—yet it has the potential to reshape our healthcare system and our personal relationships with primary care physicians like myself. Incorporated into the broader bill, the PCEA takes effect in 2026, allowing Health Savings Account (HSA) funds to be used for Direct Primary Care (DPC) memberships—up to $150 per month for individuals and $300 per month for families.

While this is a major financial and administrative breakthrough for both employers and employees, it also carries profound potential to promote longevity and healthy aging.

Direct Primary Care: Investing in Years and Quality of Life

Direct Primary Care (DPC) offers longer visits, same- or next-day appointments, direct physician access, and a proactive focus on prevention and chronic disease management. By removing barriers to continuous, personalized care, DPC aligns closely with research showing that strong primary care relationships can improve both lifespan and healthspan. A large systematic review found that greater access to primary care is associated with lower all-cause mortality and improved population health outcomes (Basu et al., 2019). Regular, coordinated care reduces the likelihood of undiagnosed conditions, delays in treatment, and fragmented care—all of which can shorten life expectancy.

Importantly, strong primary care also reduces overall healthcare costs by decreasing avoidable hospitalizations, emergency department visits, and unnecessary specialty referrals. One study analyzing Medicare data found that beneficiaries with higher primary care spending had significantly lower total healthcare costs and better outcomes, particularly in managing chronic illnesses (Basu et al., 2018). These savings directly benefit employers, insurers, and patients alike.

Employer Benefits: Health Today, Savings Tomorrow

The Primary Care Enhancement Act allows employers to integrate Direct Primary Care (DPC) into their benefits packages without jeopardizing HSA eligibility—transforming it from a “nice-to-have” perk into a strategic investment in the long-term health of their workforce.

1. Reduced Long-Term Claims
Proactive management of chronic conditions such as hypertension, diabetes, and cardiovascular disease prevents costly complications like heart attacks, strokes, kidney failure, and hospital admissions. Studies consistently show that strong primary care access is associated with lower total healthcare spending and reduced hospital utilization (Basu et al., 2018; Marmot et al., 2020). Over time, this lowers premiums and self-funded employer payouts.

2. Lower Absenteeism
With same-day or next-day access to their physician, employees receive timely treatment for acute illnesses and chronic disease flare-ups, reducing the duration and frequency of sick leave. The result is fewer productivity disruptions, particularly for positions where even one absence creates workflow bottlenecks.

3. Healthy Aging Workforce
Mid-life preventive strategies—such as controlling blood pressure, supporting metabolic health, managing stress, and encouraging physical activity—are linked to a reduced risk of dementia, cardiovascular disease, and frailty in later life (Franco et al., 2009). For employers, this translates to sustained workforce capacity, especially as more employees work beyond traditional retirement age.

4. Attractive Benefits Package
In competitive labor markets, offering DPC alongside an HSA-eligible plan signals an employer’s commitment to health and well-being. This is especially appealing to top-tier candidates who value wellness, preventive care, and work-life balance. A comprehensive benefits package can improve recruitment, retention, and overall employee satisfaction.

Table 1 summarizes these benefits

Table 1: Employer Benefits of Integrating Direct Primary Care under the PCEA


The Longevity Connection

Primary care in a Direct Primary Care (DPC) model supports the concept of “compression of morbidity”—the idea that we can extend the number of years people live in good health while delaying the onset of chronic disease and disability (Fries, 2002). For individuals, this means enjoying more years of vitality; for employers, it means having a healthier, more productive workforce for longer. Healthier employees remain active contributors, reducing the burden of disability, absenteeism, and healthcare costs, while also enriching their families and communities.

In short, DPC is about extending healthspan—the number of healthy, functional years before chronic illness begins to limit quality of life. But how can one piece of legislation, like the Primary Care Enhancement Act, combined with the DPC model, make such a difference?

The answer lies in removing the financial and psychological barriers to early, frequent, and meaningful primary care engagement.


Why Traditional High-Deductible Plans Can Work Against Prevention

If you have a high-deductible plan, your insurance won’t start covering most costs until you’ve spent several thousand dollars out of pocket—often $5,000 or more annually. This “pay until it hurts” model unintentionally discourages people from seeing their physician when symptoms first appear. Many will delay care until they have no choice, which can turn small, manageable issues into major—and costly—problems.

Even those with comprehensive insurance often get only one fully covered annual exam, with all other visits subject to co-pays or deductibles. This creates a negative incentive: patients think twice before scheduling a visit outside that annual check-up, even if they’re experiencing early warning signs of a health problem.

The result? Missed opportunities for prevention and early intervention—when treatment is most effective and least expensive.


How DPC Changes the Equation

Under a DPC membership, patients can see their physician as often as needed for a predictable monthly fee—without surprise bills or complicated cost-sharing. This freedom encourages patients to ask questions, report new symptoms early, and engage in deeper, more meaningful discussions about their health.

The benefits are significant:

  • Earlier Detection: Cancer can be caught before it metastasizes.

  • Chronic Disease Prevention: Diabetes can be addressed before it causes kidney failure or vision loss.

  • Risk Reduction: Hypertension can be managed before it leads to stroke or heart attack.

By catching and treating these conditions in their early stages, DPC improves both quality of life and life expectancy, while reducing the long-term financial burden of advanced disease management. In fact, evidence also links stronger primary care access with lower all‑cause mortality and better population health outcomes (Basu et al., 2019).

Table 2 outlines the differences between high deductible, health insurance plan and direct primary care

Table 2: key differences between high deductible, health insurance plans, and DPC plans.

Looking Ahead

With the PCEA’s provisions taking effect in 2026, forward-thinking employers have a year to:

  • Partner with local DPC practices.

  • Educate their workforce on how DPC works.

  • Integrate this benefit into broader wellness and prevention strategies.

This isn’t just about cutting costs—it’s about adding years of vitality to employees’ lives and creating a culture of health that extends well beyond the workplace. In doing so, employers can play a direct role in supporting both the longevity and productivity of their most valuable asset: their people.

References

Basu, S., Berkowitz, S. A., Phillips, R. L., Bitton, A., Landon, B. E., & Phillips, R. S. (2019). Association of primary care physician supply with population mortality in the United States, 2005–2015. JAMA Internal Medicine, 179(4), 506–514. https://doi.org/10.1001/jamainternmed.2018.7624

Basu, S., Phillips, R. S., Bitton, A., Song, Z., Landon, B. E., & Phillips, R. L. (2018). Medicare spending per beneficiary is lower for primary care physicians than for specialists. Health Affairs, 37(6), 952–961. https://doi.org/10.1377/hlthaff.2017.1392

Franco, O. H., Steyerberg, E. W., Hu, F. B., Mackenbach, J., & Nusselder, W. (2009). Associations of diabetes mellitus, fasting glucose, and insulin resistance with dementia and cognitive decline. Diabetologia, 52(12), 2610–2614. https://doi.org/10.1007/s00125-009-1514-3

Fries, J. F. (2002). Aging, natural death, and the compression of morbidity. Bulletin of the World Health Organization, 80(3), 245–250.

Marmot, M., Allen, J., Boyce, T., Goldblatt, P., & Morrison, J. (2020). Health equity in England: The Marmot Review 10 years on. Institute of Health Equity.

U.S. Congress. (2025). Primary Care Enhancement Act of 2025, Pub. L. No. 118–xxx. Incorporated into the “One Big Beautiful Bill” Act, § 71308, enacted July 4, 2025.