Carper and Thune Re-Introduce Legislation to Strengthen Chronic Disease Management

WASHINGTON, D.C. — Today, U.S. Senators Tom Carper (D-Del.) and John Thune (R-S.D.) re-introduced bipartisan legislation that will ensure high-deductible health plans (HDHPs) that are used with health savings accounts can cover care related to chronic disease management prior to a beneficiary reaching their plan deductible.

Individuals with HDHPs can access preventative care services without triggering their deductible. Currently, however, the treatment and management of chronic diseases, such as diabetes, are not considered to be preventative care services even though care for chronic disease management can mitigate future health complications. The Chronic Disease Management Act corrects this issue by covering certain chronic disease management services as preventative care, thereby improving patients’ access to the care they need and ultimately improving their health outcomes and lowering health care costs for both patients and the American health system.

“On average, six out of ten Americans battle chronic diseases every day, and need access to preventative care to stay healthy,” said Carper. “This bipartisan bill will allow patients to get the care they need to manage their chronic conditions before an emergency episode occurs without worrying about their bill. The bill will also tackle health disparities because high deductibles disproportionately impact patients that are chronically ill, low-income, and people of color. It’s a win for patients, and I’m proud to reintroduce this common-sense bill with Senator Thune.” 

“By expanding what qualifies as preventive services, more folks living with chronic diseases like diabetes, heart disease, and high blood pressure can get coverage for the services and medications they need to manage their condition, helping improve quality of life,” said Thune.“I’m proud to support this legislation that would help individuals living with chronic diseases avoid the need for higher-cost treatments down the road.”

The Chronic Disease Management Act builds off legislation that the Senators originally introduced in June 2019 and follows guidance issued by the U.S. Department of the Treasury in July 2019. In July 2019, the IRS issued a notice expanding its interpretation of what constitutes preventive care to include certain items and services that are prescribed to someone with certain chronic conditions. Those items or services can be considered preventive when they are prescribed to an individual with certain chronic conditions and if they are low-cost and prevent the worsening of a chronic condition or the development of a secondary condition. The notice also contains a list of specific items and services that meet the new criteria for preventive care for chronic conditions, not to include other items at this time.

In 2020, the Kaiser Family Foundation reported that of employers offering an HSA-qualified health plan, 48% of employers with over 5000 employees and 29% of employers with over 200 employees reported implementing a benefit design that expanded pre-deductible coverage. A 2021 Employee Benefit Research Institute survey of employers reported that 81% of employers would expand the number of services if allowed by law.