PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the House Committee on Ways and Means.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Roy, Chip [R-TX-21] · R–TX
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the House Committee on Ways and Means.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: May 6, 2025. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.1140 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.1140 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.1140 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.1140 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.
PlainBill explanation
Based on the full Introduced in House · 2025-02-07 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed Direct Medical Care Freedom Act of 2025 would change federal tax rules for people receiving medical care for a fixed recurring fee. Qualifying arrangements would not count as health plans under one specified tax rule, and their fees would receive medical-expense treatment. Fees for arrangements provided through employment would be reported on Form W-2.
This Act may be cited as the Direct Medical Care Freedom Act of 2025.
A direct medical care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).
an arrangement under which such individual is provided medical care provided by medical care practitioners if the sole compensation for such care is a fixed periodic fee.
(b) Direct medical care service arrangement fees treated as medical expenses
(c) Reporting of direct medical care service arrangement fees on W–2
in the case of a direct medical care service arrangement (as defined in section 223(c)(1)(E)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee.
The bill would exclude qualifying direct medical care arrangements from the definition of a health plan specifically for Internal Revenue Code section 223(c)(1)(A)(ii). This exclusion is limited to that tax provision.
Section 223(c)(1) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph:
A direct medical care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).
To qualify, an arrangement would have to provide medical care with a fixed recurring fee as the only payment for that care. Restricting an arrangement to particular kinds of care or practitioners would not, by itself, disqualify it.
The term direct medical care service arrangement means, with respect to any individual, an arrangement under which such individual is provided medical care provided by medical care practitioners if the sole compensation for such care is a fixed periodic fee.
An arrangement shall not fail to be treated as a direct medical care service arrangement merely because such arrangement is restricted to any subset of medical care or medical care practitioners.
Eligible practitioners would be physicians, nurse practitioners, clinical nurse specialists, and physician assistants, subject to the cited Social Security Act definitions. The bill would use the definition of medical care in Internal Revenue Code section 213(d).
the term medical care practitioner means an individual who is— (I) a physician (as defined in section 1861(r)(1) of the Social Security Act), or (II) a nurse practitioner, clinical nurse specialist, or physician assistant (as such terms are defined in section 1861(aa)(5) of the Social Security Act).
the term medical care has the meaning given such term in section 213(d)).
The bill's medical-expense provision would add “any direct medical care service arrangement” to Internal Revenue Code section 223(d)(2)(C). The existing provision is not reproduced in the supplied text.
(b) Direct medical care service arrangement fees treated as medical expenses Section 223(d)(2)(C) of such Code is amended by striking or at the end of clause (iii), by striking the period at the end of clause (iv) and inserting , or, and by adding at the end the following new clause: (v) any direct medical care service arrangement.
For a qualifying arrangement provided in connection with employment, the bill would require Form W-2 reporting of the total fees for that employee's arrangement.
(c) Reporting of direct medical care service arrangement fees on W–2 Section 6051(a) of such Code is amended
(18) in the case of a direct medical care service arrangement (as defined in section 223(c)(1)(E)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee.
The proposed amendments would apply to months beginning after December 31, 2024, in tax years ending after that date.
The amendments made by this section shall apply to months beginning after December 31, 2024, in taxable years ending after such date.
The supplied May 6, 2025 source snapshot records that the bill was introduced in the House and referred to the House Committee on Ways and Means on February 7, 2025.
Source snapshot updated 2025-05-06T12:42:02Z. 2025-02-07: Referred to the House Committee on Ways and Means. 2025-02-07: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-02-07. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion does not extend to other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion does not establish the absence of earmarks in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out or preferential exception beyond the main policy's ordinary coverage was identified in the complete supplied introduced text. This conclusion is limited to that version.
Full text preserved for this analysis. Legislative record snapshot: May 6, 2025. How PlainBill uses AI