Schneider, Wenstrup Introduce Bipartisan Primary and Virtual Care Affordability Act
WASHINGTON – U.S. Representatives Brad Schneider (IL-10) and Brad Wenstrup (OH-02) announced the introduction of bipartisan legislation to improve the affordability of primary care and telehealth for individuals with high-deductible health insurance plans (HDHPs).
In 2020, Congress authorized as part of the CARES Act, first dollar coverage of telehealth services for HSA-eligible HDHPs, which increased patient access to those services. This provision is set to expire on December 31, 2021. The Primary and Virtual Care Affordability Act (H.R. 5541) would extend the telehealth provision through December 31, 2023 and also give HDHPs the flexibility to waive the deductible for primary care services.
"Financial burdens should not prevent Americans from seeing their primary care doctor to discuss critical health care needs," said Schneider. "The upfront costs of high-deductible health plans discourage too many Americans from getting the preventative care they need, leaving issues untreated and ultimately resulting in higher costs and poorer outcomes down the line. I appreciate Rep. Wenstrup joining me to introduce this bipartisan legislation to improve the health care options available to patients with high-deductible plans."
"I believe our American health care system should put a greater emphasis on keeping people healthier for longer, to improve the patient's quality of life while reducing their out of pocket costs. That's why I'm proud to co-lead the Primary & Virtual Care Affordability Act, which will encourage patients to further engage in preventative care. We must build off of the telehealth flexibilities that COVID-19 ushered in and ensure continued access to telehealth for patients in High Deductible Health Plans," said Wenstrup.
The use of HDHPs has drastically increased among individuals and employers in recent years. According to the Kaiser Family Foundation, the percentage of covered workers enrolled in an HDHP has more than doubled over the last decade, with 13% enrolled in HDHPs in 2010 and 31% in 2020.
While HDHPs have low monthly premiums, they require the plan holder to pay 100% of most medical costs before insurance kicks in. Evidence shows that the high initial out-of-pocket costs often deter individuals from seeking necessary primary care services, a problem that can lead to worse health outcomes and much higher future healthcare costs.
The COVID-19 pandemic also highlighted the value of telehealth services. With hospitals over capacity and people confined to their homes to prevent the spread of COVID, more medical appointments had to be conducted virtually. In addition to being instrumental during the pandemic, telehealth can increase access to care in areas with provider shortages, and ensures that patients who can't travel are still able to see a doctor. By allowing HDHPs to waive the deductible for primary care and telehealth, this bill increases patient access and gives patients and clinicians the freedom to choose the right care.
"The American Academy of Family Physicians applauds the introduction of the Primary and Virtual Care Affordability Act, which would extend flexibilities for telehealth services and ensure patients can utilize primary care services before they reach their deductible in high-deductible plans—protecting patients from increasing health care costs and supporting their primary care needs. Patients need access to primary care and family physicians for key preventive services, for help managing their chronic conditions, and to address acute medical needs that, if left untreated, could result in emergency room visits, hospitalizations, or other avoidable costly outcomes," said Sterling N. Ransone, Jr., MD, FAAFP, President, American Academy of Family Physicians.
"The Partnership to Advance Virtual Care thanks Representatives Schneider and Wenstrup for their bipartisan leadership on this time-sensitive virtual care issue, which is not tied to the duration of the COVID-19 public health emergency the way other telehealth provisions are," said Mara McDermott, Executive Director of The Partnership to Advance Virtual Care. She added, "By extending the safe harbor allowing those with HSA-eligible HDHPs to have telehealth services covered on a first-dollar basis, H.R. 5541 will ensure continued, uninterrupted access to important telehealth services for millions of Americans with employment-based health coverage.
"We thank Representatives Schneider and Wenstrup for introducing the Primary and Virtual Care Affordability Act. This legislation will extend much-needed flexibilities for millions of employees with HSA-eligible HDHPs. As the pandemic continues, this bill is essential to ensuring continued access to telehealth services, including primary care and behavioral and mental healthcare," said Rachel Stauffer, Director of Government Affairs, 98point6.
"During the COVID-19 pandemic, Congress enabled employers to offer pre-deductible coverage for telehealth services, expanding access to care and reducing out-of-pocket costs for millions of Americans," said Alliance for Connected Care executive director Krista Drobac. "This bill will ensure individuals with HSAs continue to have ready access to virtual-care and primary care services while remaining eligible to make and receive contributions to an HSA."
"Broad access to virtual care is urgently important to helping people everywhere take control of their health – particularly in the aftermath of the public health emergency. Noom applauds Representatives Schneider and Wenstrup for their leadership to enable Americans with high-deductible plans to have continued access to these services," said Michal Rosenn, General Counsel, Noom.
Telehealth has been a critical support for patients throughout the pandemic, and employers know the value of providing 1st-dollar coverage for this valuable service," said Annette Guarisco Fildes, President and CEO of The ERISA Industry Committee (ERIC). "The Primary and Virtual Care Affordability Act is badly needed, because it will protect these benefits for tens of millions of workers, who otherwise will lose access next year. And it also provides improved access to primary care for our employees and their families enrolled in HSA-qualified plans.
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