AONN+ Joins Organizations in Letter to Congress on Reinstatement of Telehealth Policy

CRANBURY, N.J., January 25, 2022 - The Academy of Oncology Nurse & Patient Navigators (AONN+) joined the Alliance for Connected Care and other organizations in writing to Congress and urging the reinstatement of a policy that permits pre-deductible coverage of telehealth services for those in high-deductible health plans.

To provide relief for individuals and businesses impacted by the COVID-19 pandemic, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March 2020. The CARES Act has a provision that allows high-deductible health plans (HDHPs) to temporarily cover telehealth and other remote care services at little to no cost, even before the plan subscriber reaches their deductible. This provision expired on December 31, 2021.

According to the letter circulated by the Alliance for Connected Care, this telehealth provision provided for a meaningful expansion of healthcare access for 32 million Americans during the pandemic, particularly those with limited incomes who may otherwise have avoided care due to out-of-pocket costs.

Jamie Callahan, chair of the AONN+ Policy & Advocacy Committee, said, “Telehealth availability helps to keep immunocompromised patients at home, and offers more flexibility to those who need to travel long distances for care otherwise. This proposed change would help address financial barriers to care our patients experience to telehealth care.”

“I would like to add that HDHP-HSA plans affect a large percentage of post-treatment cancer survivors,” said Deborah Lefkowitz, a new member of AONN+. “According to study results published in JAMA Network Open, 44 percent of privately insured adult cancer survivors were enrolled in HDHP-HSA plans between 2013 and 2018.¹ Thus, continued access to telehealth supports affordable access to care for a large number of post-treatment survivors.”

High-deductible health plan (HDHP) has lower premiums and higher deductibles than a traditional health insurance plan; HDHP plan subscribers need to pay more of the healthcare costs before the insurance plan starts to pay. An HDHP plan can be combined with a health savings account (HSA), allowing subscribers to pay for certain medical expenses with money free from federal taxes.

The Alliance for Connected Care is a non-profit organization with members from across the healthcare and technology spectrum, representing insurers, retail pharmacies, technology and telecommunications companies, and healthcare entrepreneurs.

Reference

1. Association Between High-Deductible Health Plans and Disparities in Access to Care Among Cancer Survivors. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767589.

The full letter can be viewed here:

January 13, 2022

Dear Chairman Wyden, Ranking Member Crapo, Chairman Neal and Ranking Member Brady:

Thank you for your ongoing leadership to expand access to virtual care. As you know, virtual care and telehealth have been lifelines for millions of Americans throughout the pandemic and will continue to be essential tools to ensure access to quality health care even once the pandemic ends. We write today to encourage you to reinstate the recently expired, bipartisan policy changes that allowed 32 million Americans in the employer market with high-deductible health plans coupled with Health Savings Accounts (HDHP-HSAs) to receive telehealth benefits from their employer or health plan pre-deductible.¹

As you know, this safe harbor flexibility unfortunately expired on December 31, 2021. Given the ongoing pandemic and recent surge in variants of concern including Omicron, as well as the related behavioral health and chronic disease management challenges, it is critical that Congress reinstate this flexibility so more Americans can access telehealth pre-deductible.

Americans with HDHP-HSAs must meet minimum deductibles defined in statute before the cost of telehealth can be covered by their employer or health plan. Congress took swift bipartisan action as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (P.L. 116-136) to ensure that employees could receive covered telehealth services before their deductible is met by allowing employers and health plans to provide pre-deductible coverage for such services. This commonsense policy helped ensure that families could access vital telehealth services – including virtual primary care and behavioral health services – prior to having to meet their deductible. In fact, according to a survey by the Employee Benefit Research Institute (EBRI), about 96 percent of employers adopted pre-deductible coverage for telehealth services as a result of this provision.²

The ability to offer pre-deductible telehealth services for employees is a meaningful expansion of health care access for 32 million Americans. Notably, according to unpublished estimates from EBRI, over 50 percent of individuals with an HSA live in zip codes where the median income is below $75,000 annually. Reaching the deductible threshold of at least $1,400 for an individual and $2,800 for a family can be a financial strain. The safe harbor enabled important expansions of access to care during the pandemic for individuals who may otherwise have avoided care due to out-of-pocket costs.

The undersigned organizations strongly urge you to reinstate the virtual care provisions in the CARES Act retroactively for individuals with HDHP-HSAs in the upcoming appropriations package in February. This is especially important given plan year 2022 has already begun and many individuals have already selected this form of coverage. There is also bipartisan, bicameral legislation before your committees to extend this flexibility.³ As the pandemic continues, particularly in light of the surge in cases due to the Delta and Omicron variants, individuals need continued access to these vital services. We strongly encourage you to consider reinstating this provision to allow employers and health plans to offer telehealth pre-deductible.

Thank you for your consideration of this important request.

References

1. HSA-Eligible Health Plans Embrace Changes to Better Serve Americans with Chronic Health Conditions. https://www.ahip.org/wp-content/uploads/202109-AHIP_HDHP-Survey-v03.pdf
2. Employer Uptake of Pre-Deductible Coverage for Preventive Services in HSA-Eligible Health Plans. https://www.ebri.org/docs/default-source/ebri-issue-brief/ebri_ib_542_hsaemployersur-14oct21.pdf
3. Top legislation addressing this need includes S. 1704 / H.R.5981 - Telehealth Expansion Act of 2021, H.R.5541 - Primary and Virtual Care Affordability Act, and S. 2097 – TELEHEALTH HSA Act of 2021.

About the Academy of Oncology Nurse & Patient Navigators, Inc. (AONN+)
The Academy of Oncology Nurse & Patient Navigators, Inc. (AONN+), is the largest national specialty organization dedicated to improving patient care and quality of life by defining, enhancing, and promoting the role of oncology nurse and patient navigators. The organization, which has more than 8900 members, was founded in 2009 to provide a network for all professionals involved and interested in patient navigation and survivorship care services in order to better manage the complexities of the cancer treatment process. www.aonnonline.org.