WASHINGTON, D.C. — This week, U.S. Senators Tom Carper (D-Del.) and John Thune (R-S.D.) reintroduced bipartisan legislation to 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. The bill builds off legislation they introduced in June 2019 and follows guidance issued by the U.S. Department of the Treasury in July 2019.
“More than 50 percent of American employees are now enrolled in high-deductible health plans (HDHPs), which can present financial challenges to those living with chronic diseases like arthritis, diabetes and cancer,” said Carper. “Proactively managing these diseases helps prevent emergency episodes, thereby saving lives and avoiding costly procedures. This common sense bill with Senator Thune will help improve health care outcomes for patients with chronic conditions by allowing those enrolled in HDHPs to have greater flexibility in accessing the care they need, without the fear of triggering their deductibles.”
“There are 60 percent of American adults living with a chronic disease, which if left unmanaged, can cause further health complications and increased health care costs,” said Thune. “By expanding what qualifies as preventive services, more folks living with chronic diseases can get coverage for the services and medications they need to manage their condition, helping improve quality of life.”
“Employers have shown they will utilize flexibility to offer more high-value benefits pre-deductible – that’s because it makes sense to remove barriers for patients with diabetes or asthma or heart disease to get the drugs and services they need to stay healthy,” said Katy Spangler, co-director of the Smarter Health Care Coalition. “As the nation continues to recover from the public health and economic consequences of the COVID-19 pandemic, common-sense, bipartisan bills like this one will become even more important for patients and the health care system.”
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.
The Kaiser Family Foundation published survey results showing 48 percent of very large employers say they changed the services or products individuals with chronic conditions could receive before meeting their deductibles after 2019 changes in federal rules for which the Coalition advocated.