Katie Mahoney Katie Mahoney
Former Vice President, Health Policy, U.S. Chamber of Commerce


November 15, 2022


Fill Me In: Since the beginning of the COVID-19 pandemic, telehealth services have become integral to patients accessing care, reducing travel and wait time when seeing doctors and helping to address longstanding disparities among communities of color.

Flexibility in benefit design has been critical for increasing access to this treatment modality and is now more widely available due to the passage of the Coronavirus Aid Relief and Economic Security (CARES) Act in March 2020. In the CARES Act, Congress expanded the ability for certain high deductible health plans (HDHP) to offer telehealth health services on a pre-deductible basis while maintaining Health Savings Account (HSA) eligibility. Without this flexibility, these HSA-eligible HDHPs would not be able to permit beneficiaries to access health care services virtually until after the deductible is met.

This expansion of telehealth services increased the availability of primary care services for patients to engage with health care providers virtually, which was critical in the early phases of the pandemic and has proven to reduce wait times to access care. It also saves employees from taking additional time away from work to commute to the provider and wait for an appointment, which in many instances served as barriers to accessing services.

Without action from Congress, this flexibility will end at the end of 2022, potentially cutting off access to vital health services for millions of Americans.

What’s at Stake: Telehealth access is beneficial for patients across the care and socioeconomic spectrum, including when facilitating access to:

  • Mental Health: Virtual appointments for mental health services expands the ease and affordability of care for millions of Americans. Without an extension of current flexibility in plan design, employees with HSA-eligible HDHPs would only be able to access telehealth services after satisfying the plan’s deductible, creating another barrier to treatment.
  • Maternal and Prenatal Care: Accessing care through telehealth also may chip away at disparities in access to maternal and prenatal care by giving patients more choice and flexibility in providers and scheduling through a virtual off-site method.
  • Underserved Areas: Telehealth services also facilitate the ability for patients in underserved areas to access vital care where fewer providers or specialists are available.

Telehealth is Popular Among Employees: Employees report positive sentiment about access to telehealth and telemental health services. According to a 2021 Morning Consult National Tracking Poll sponsored by the Alliance to Fight for Health Care:

  • 72% of people used telehealth for an appointment with their primary care physician or a physician within their insurance network
  • 84% rated their or their family member’s previous telehealth visit(s) as good or excellent
  • One-fifth of insured American adults have personally had a telehealth appointment for their mental health
  • Nearly two-thirds are willing to receive mental health care virtually through a telehealth system

It’s Also Good for Business: Data shows that employers who offer a variety of plan options have employees who are motivated to stay with their companies, reducing recruiting and vacancy costs. Additionally, employers who offer wellness programs generally have a healthier workforce and spend less on direct medical costs and lost labor.

The Good News: There is bipartisan, bicameral support in Congress to extend telehealth access by providing flexibility for plans and employers to offer telehealth pre-deductible in HSA-eligible plans, and the Chamber is pressing Congress to adopt this legislation in any end-of-year spending package.

Bottom Line: Providing telehealth services is popular among and beneficial to employers and employees alike. These services provide more flexibility to patients, and Congress should extend business’ ability to provide them to their workforce to further improve access to quality, affordable, and accessible care for millions of Americans.

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    About the authors

    Katie Mahoney

    Katie Mahoney

    Katie W. Mahoney is the former vice president of health policy at the U.S. Chamber of Commerce.