Debate: Should HSA-Compatible Plans Cover Telehealth Before the Deductible?

Byrnes: The extension of pre-deductible telehealth benefits should definitely be temporary. HDHPs have restrictions for a reason. Those restrictions with respect to deductibles are what render participants eligible to make HSA contributions. Allowing unlimited pre-deductible remote health care services negates the rationale behind allowing triple-tax-preferred HSAs in the first place.

Bloink: In cases involving minor issues, pre-deductible telehealth care should always be permitted — if for no other reason than it significantly decreases the cost and inconvenience of obtaining health care in America. This is how industries evolve and grow in the face of rising costs and an extraordinarily tight labor market. It’s just another way to add efficiency and improve productivity, all while improving the health care experience for the average American.

Byrnes: We have vaccines that keep people safe from severe illness and reduce the risk of in-person treatment, which is the most effective type of medical care. We have to acknowledge that there’s only so much that a physician can do in a remote setting. There’s no reason to make every rule implemented during the pandemic permanent. Many of these rules complicate an already complex set of preferential tax rules and we should be focused on making the code simple enough for ordinary Americans to actually understand it.

Bloink: The fact is, we have to change with the times. The pandemic taught us many important lessons that we shouldn’t forget just because the country — and the world — is returning to “normal.” Many Americans don’t seek necessary medical care because of the hoops they’re forced to jump through — not to mention the expense. Telehealth is a cost-effective way to offer basic care for Americans. Because of the reduced cost, I don’t see any reason why it shouldn’t be offered on a pre-deductible basis for HDHP participants.

Byrnes: Taxpayers with HDHPs are given the significant tax benefits of contributing to an HSA because of the restrictions imposed on HDHPs themselves. Yes, we expanded the rules to allow HDHPs to cover telehealth services on a first-dollar basis during the pandemic. That was in reflection of the fact that it was the only way some taxpayers could access their health benefits during an unprecedented pandemic — but it doesn’t mean that we should focus on encouraging telehealth services as a long-term solution to the problems surrounding health care in America.

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