A bill called the Telehealth Benefit Expansion for Workers Act was recently introduced as a way to expand access to employer-sponsored health benefits by classifying telehealth as an excepted benefit.
Support for the bill came from one of the co-sponsors Suzan DelBene who said that “COVID-19 put a new emphasis on telehealth and showed how impactful and convenient it can be for working families to get care similar to an in-office nurses station. Over the past two years, many employers have begun offering these telehealth services to their workforce. Even with many businesses returning to in-person work, we shouldn't be turning our backs on the benefits of telehealth. We're introducing the Telehealth Benefit Expansion for Workers Act so workers can continue receiving this care from the comfort of their homes and on their own schedule.”
In another article on the topic Paul Johnson, CEO of Redirect Health offers his take.
While this legislation will have a monumental impact on public health insurance, it may not do the same for private plans. Offering your employees telehealth, at your additional cost, won’t lower your rate through the traditional insurance system.
But today, 60% of American employers have opted out of the traditional system and built self-insured plans. With this system, any reduction in claims goes right into the employee and employer’s pockets. By increasing the benefits, employers get higher productivity and a better advantage in employee recruitment and retention.
Last year others similar bills, The Telehealth Extension Act and the Telehealth Extension and Evaluation Act, were introduced. At that time the American Association of Telemedicine expressed its opinion that there should be a permanent law that allows telehealth and remote care services to be treated as an excepted benefit for certain employees.
Under current law, when telehealth or remote care services are provided by an employer, the benefit is considered a “group health plan” under ERISA, which triggers a number of mandates. If these mandates are not met, the employer is subject to per-day, per-violation penalties, unless otherwise specified. Neither telehealth nor remote care services are currently included among the excepted benefits under ERISA. This prevents the employer from offering these services to all employees, not just those full-time employees who elect coverage in an employer’s plan.
“As proven during the public health emergency, telehealth and remote care services offer access to high-quality care that provides an essential lifeline to U.S. workers,” said Ann Mond Johnson, CEO of the ATA. “As a result, telehealth has emerged as a cost-effective solution to ensure working Americans have access to medical care, including behavioral and mental health services, regardless of their coverage status or eligibility. It is time for Congress to take action to permanently add telehealth and remote care services as an excepted benefit for these employees.”
Along these same lines the Alliance to Fight for Healthcare, gave this statement last year.
The Coronavirus Aid Relief and Economic Security (CARES) Act provided employers with the temporary ability to provide telehealth without applying a deductible to employees with a health savings account. This flexibility expires on December 31, 2021. We strongly support your legislation, HR 5981, which would permanently extend this flexibility and urge Congress to pass HR 5981 before this temporary flexibility expires.
During the pandemic, about 4 in 10 adults in the U.S. reported symptoms of anxiety or depressive disorder, up from one in ten adults who reported these symptoms from January to June 2019.[ In the face of this challenge, employers pivoted to provide new and expanded mental and behavioral health resources for their employees. Despite economic uncertainty, 68% of large employers added or expanded benefits or resources to meet employee needs in response to the pandemic.
Already an area of acute focus, employers doubled down on mental health and emotional well-being to meet employee needs. In an informal survey of large employers, 85% said supporting and/or expanding access to mental health care for employees was a top priority for their organization. In another survey conducted a year into the pandemic, 50% of employers reported that employees were taking greater advantage of company mental health resources. This includes expanded access to virtual care and on-demand telemental health; enriched EAP benefits to help employees manage their wellness; newly eliminated copayments for mental health encounters; and added voluntary and supplemental benefits aimed at addressing overall wellbeing (e.g. financial wellness, caregiving supports, enhanced leave, sleep management, and more).
According to the Business Group on Health’s (BGH) 2022 “Large Employers’ Health Care Strategy and Plan Design Survey,” a true silver lining of the pandemic has been the significant investments made in virtual and mental health offerings, many of which will become permanent. These include expanded telehealth or virtual health offerings (76%), better access to virtual health (68%) and new mental health benefits (62%). When it comes to mental health treatment, employers are also enhancing access through reduced out-of-pocket costs for employees. For 2022, 75% of large employers are offering access to lower- or no-cost mental health support through their telemental health provider and 33% are offering lower cost counseling services at the worksite – bringing services directly to employees wherever they are. Without your legislation, employers will be required to charge employees more to access this care; throwing up another barrier to treatment.
The need for this type of service is underscored by a survey released in March of 2022, by the American Medical Association which showed that nearly half of the respondents (46.8%) said they conduct 1% to 20% of their patient visits via telehealth each week. On the other end of the spectrum, 21.3% of respondents said they conduct more than 80% of their visits virtually every week.