New Legislation Aims to Widen First-Dollar Telehealth Coverage

This week, six US representatives and senators introduced an extension of the CARES Act known as the “Telehealth Expansion Act,” which would allow Americans with Health Savings Accounts (HSA) to gain telehealth access without the need to meet a deductible.

Reps. Michelle Steel (R-CA), Susie Lee (D-NV), Adrian Smith (R-NE), and Brad Schneider (D-IL), and Sens. Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) introduced the new legislation.

Signed in March 2020, the CARES Act allowed HSA-qualified high-deductible health plans to cover telehealth services prior to reaching the deductible amount. Additionally, it allowed individuals to select and purchase telehealth services independent of their high-deductible health plan without any impact on their HSA eligibility.

The new act would make this waiver permanent.

“During the COVID-19 pandemic, telehealth became an important tool used by families, seniors, and rural communities to access quality, affordable health care,” said Steel in a press release. “The expiration of the CARES Act provision will negatively impact more than 32 million HSA enrollees and twenty percent of the American workforce, who currently enjoy the option to utilize telehealth. I am proud to lead this commonsense bipartisan measure to permanently expand access to telemedicine.”

An expansion of the CARES Act, this bipartisan and bicameral legislation aims to promote rather than curb telehealth use. Those who support this legislation noted that telehealth is critical in helping Americans access care, and limiting its availability would be harmful.

“Telehealth has become a key component of how Americans everywhere, especially those in rural areas, access the health care services they need,” said Smith in a press release. “The first dollar coverage waiver provided by the CARES Act has proven to be a useful resource, and I thank Representative Steel for her leadership to make this flexibility permanent.”

US lawmakers are increasingly supporting legislation that aims to expand telehealth access.

In February, six US House representatives introduced the Telehealth Benefit Expansion for Workers Act to provide American workers with access to employer-sponsored telehealth benefits.

This bipartisan bill would allow employers to offer workers standalone telehealth benefits that operate in a similar way to dental and vision benefits, remaining separate from traditional medical healthcare coverage. It would also extend this flexibility to workers who engage only in seasonal or part-time employment.

In December 2022, President Joe Biden signed an end-of-year spending bill that included a two-year extension of pandemic-era telehealth and hospital-at-home waivers.

These flexibilities included eliminating geographic restrictions on originating sites for telehealth services, allowing Medicare beneficiaries to receive care regardless of location, and enabling federally qualified health centers and rural health centers to continue providing telehealth services.

These waivers will remain in place through 2024.