July 1, 2026
The Honorable Rick Allen
Chairman
U.S. House Committee on Education and Workforce
Health, Employment, Labor, and Pensions Subcommittee
Washington, DC 20515
The Honorable Mark DeSaulnier
Ranking Member
U.S. House Committee on Education and Workforce
Health, Employment, Labor, and Pensions Subcommittee
Washington, DC 20515
Dear Chairman Allen, Ranking Member DeSaulnier, and Members of the Subcommittee,
On behalf of National Taxpayers Union, the nation’s oldest taxpayer advocacy organization, we commend you for holding a hearing entitled “Direct Contracting: A Prescription for Lower Health Care Costs.” Health care now accounts for nearly one-fifth of the entire American economy, and direct contracting between patients and providers has the potential to slow the growth of spending while enhancing flexibility for patients.
NTU has long supported legislative solutions that remove unnecessary barriers to Direct Primary Care (DPC) arrangements and Health Savings Accounts (HSAs). As such, we applaud Congress for enacting reforms in the Working Families Tax Cuts that classify DPC arrangements as a qualified medical expense, which allows individuals to use HSA funds to pay DPC subscription fees.
We urge the Subcommittee to continue exploring innovative solutions that cut out middlemen and allow patients and providers to contract directly. Administrative costs account for approximately 15% to 25% of overall health care expenditures, and reducing the layers of intermediaries between doctors and patients represents a real opportunity to get a handle on health care costs.
Thank you for your leadership on this issue. NTU stands ready to assist the Subcommittee in crafting solutions that increase transparency and competition in our nation’s bloated and opaque health care sector.
Sincerely,
Alexander Ciccone
Policy and Government Affairs Manager
National Taxpayers Union