Big News for DPC and Brain Health Innovation
What the "Big, Beautiful Bill" means for practitioners
With the passage of H.R. 1, Congress has enacted long-awaited changes to IRS rules regarding Direct Primary Care (DPC). Beginning next January, more than 61 million Americans with Health Savings Accounts (HSAs) will be allowed to use those pre-tax funds to pay for a monthly DPC agreement—often under $150/month—with the primary care doctor of their choice.
For years, DPC physicians and patients have operated in a legal gray area. Now, the federal government has formally acknowledged what many of us have known for a long time: DPC is not insurance, and it should be treated as a legitimate, advanced model of care—one that is both patient-centered and prevention-focused.
But while this is a long-overdue win for the DPC movement and a green light for innovation, this bill isn’t good news for everyone.
First, the Opportunity
Let’s talk about what this change makes possible:
✅ HSA-funded DPC memberships:
Patients can now use HSA dollars to cover affordable monthly DPC fees without risking tax penalties or HSA disqualification.
✅ Employer-sponsored DPC plans:
Even companies with high-deductible health plans (HDHPs) can offer DPC memberships to employees—with no copays or cost-sharing required.
✅ Better integration with insurance:
Monthly DPC fees now count toward a patient’s deductible under their HDHP, further closing the gap between membership-based and traditional care.
✅ Momentum from big employers:
Major corporations like Amazon and Boeing, alongside coalitions like the Purchaser Business Group on Health, now have the green light to scale DPC offerings across their workforces.
✅ Federal recognition of DPC:
The IRS and U.S. health code have formally recognized DPC as a valid primary care payment model, distinct from traditional insurance.
Now, the Trade-Offs
While this bill opens new doors for innovation in healthcare delivery, it’s also part of a larger tax and spending package that contains significant cuts and constraints for other parts of the healthcare system—particularly Medicaid.
In its current form, H.R. 1 is heavily skewed toward individuals who:
Have stable, white-collar employment
Qualify for and contribute to HSAs
Work for companies offering HDHPs
That means the bill does little to support the 80+ million Americans on Medicaid, many of whom already struggle to access consistent primary care—let alone innovative models like DPC. In fact, some health policy experts argue that the broader implications of this legislation could widen the equity gap in access to preventive and relationship-based care.
This tension highlights a growing divide in American healthcare: those who can pay for proactive care—and those who remain locked into a broken, reactive system.
What This Means for Brain Health
At TruNeura, our mission has always been to democratize access to proactive, personalized brain health care. We believe that reversing cognitive decline, improving mental clarity, and extending health span should not be luxuries reserved for the affluent.
The changes in H.R. 1 don’t solve this challenge, but they do create a viable business model for forward-thinking clinics who want to serve working adults, retirees, and employer-covered populations.
With HSA-funded DPC now on the table, brain health clinics can:
Launch a membership model that includes cognitive screening, root-cause testing, group coaching, and lifestyle-based interventions
Partner with employers to offer zero out-of-pocket brain health memberships for their employees
Create long-term, scalable relationships with patients outside of insurance billing headaches
And as the DPC movement grows, we have a responsibility to use this new foundation to build inclusive, community-based models that reach beyond the traditional DPC demographic.
The Time to Build a Brain Health Membership Is Now
This new legislation creates a rare alignment between policy, employer demand, patient empowerment, and clinical innovation.
It doesn’t solve every problem—and it introduces new ones that deserve serious attention—but for clinics ready to deliver advanced primary care focused on brain health, this is the moment to act.
If you’ve been waiting for a sign to launch your brain health program, this is it.
✅ A validated payment model
✅ A supportive policy environment
✅ Growing employer demand
✅ Millions of people looking for help
→ Let’s build the future of brain health—together.