Expiring Telehealth Benefits

To qualify as a high deductible health plan (HDHP), the plan must require the participant to meet their deductible before covering most non-preventative services. Under the CARES Act pandemic relief, HDHPs were permitted to cover telehealth and other remote services on a first-dollar basis (i.e., before the participant met their deductible) without risking disqualification. Thus far, the telehealth relief was allowed to expire as of December 31, 2021—meaning that expanded telehealth coverage was no longer available for HDHP participants as of January 1. Legislation has been introduced to continue the favorable treatment of telehealth coverage, but has yet to become law.

We asked two professors and authors of ALM’s Tax Facts with opposing political viewpoints to share their opinions about whether expanded telehealth coverage options should be renewed for HDHPs going forward.

Below is a summary of the debate that ensued between the two professors.

Their Votes:







Byrnes











Bloink





Their Reasons:

Byrnes: Employees with HDHPs are afforded 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.

Bloink: We finally have the technology in place to make cost-effective telehealth work for nearly every American. Very few Americans lack access to at least a basic smartphone with video capabilities. There’s no reason why Americans shouldn’t benefit from the cost savings that telehealth coverage offers if they want to take advantage of that option. All too often, lower income Americans allow their conditions to worsen because they can’t afford the high cost of visiting their primary care doctor. This provides a lower cost option that we shouldn’t pass up.

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Byrnes: Now, 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. 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: Telehealth and other remote health options are an efficient and effective way to get health services to Americans who otherwise might have difficulty getting the advice and care that they need. Not all Americans have the resources they need to visit a doctor in person whenever they have a question about their health. We should encourage telehealth as a cost-effective alternative to a doctor’s visit—which many lower income Americans are more likely to forgo if they don’t have this option.

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Byrnes: Remote services might have played a critical role in getting Americans access to healthcare advice during the pandemic. Now, our focus should be on finding solutions to allow people to return safely to the doctor’s office for their care. At some point, we have to shift our focus toward living with the pandemic and helping businesses readjust to our new normal.

Bloink: We have to face facts. We're nowhere near out of the woods when it comes to this pandemic. Telehealth options fill the gaps to keep America safe. We know that we don’t need to continue every pandemic-related benefit introduced during the height of the pandemic. Telehealth benefits, however, cost us very little and provide an important benefit that can’t be overlooked even as we all work toward returning to a more normal lifestyle.