Many op-eds have been written about H.R. 1, the One Big Beautiful Bill Act (OBBBA). This law includes hundreds of provisions and touches almost every sector of the American economy. At the Connected Health Initiative (CHI), we are focusing on a few key pieces of this law that are big wins for health innovation and represent huge achievements for CHI’s advocacy.
Wins for Digital Health Innovation
CHI has long advocated for first-dollar coverage of telehealth services, and Congress listened. The OBBBA permanently allows for health savings accounts (HSAs) to be used on telehealth services, even before the deductible of the associated High Deductible Health Plan (HDHP) is met for the year. Millions of Americans are enrolled in HDHPs and use their HSAs to fund their healthcare throughout the year, but often they must first meet a deductible. Now, telehealth joins preventive and contraceptive care as services that can be reimbursed with HSA funds before meeting the deductible. This change makes permanent a waiver established during the COVID-19 pandemic, which allowed many Americans to safely access their care, and continues to give HDHP members choice and flexibility in meeting their health needs. In addition, telehealth services allow providers to better serve their patients and provide the necessary care. Ensuring first-dollar coverage for telehealth secures a key win for providers and for patients.
Another win for health innovation comes in the requirements for Rural Health Transformation grants. The legislation makes available $10 billion per year for five years to states for the purposes of improving and expanding rural healthcare. To secure this funding, states must submit a plan outlining their intentions on spending the funds, which may include specifications on training for healthcare providers on the use of technology-driven health solutions, including remote patient monitoring and artificial intelligence. The plan may also include specifications for the use of technology-driven solutions to monitor chronic diseases, information technology improvements, and ways to support value-based care models. These specifications in state plans demonstrate Congress’s interest in and commitment to digital medicine, remote monitoring, and health innovation. CHI is a strong advocate for value-based care modalities and other methods of improving health services while decreasing costs, and we are pleased to see Congress continue to invest in these key goals. We hope that these grants to states will spur additional innovation in health technology and incentivize growth all over the country, not just in rural areas.
Next Steps to Build a Healthier Future
While these policies are key foundations for the continued usage of health innovation, we need more to solidify the momentum toward value-based care. Congress can make a number of fixes to ensure digital health technology is available and affordable for all patients.
Medicare Coverage of Telehealth Services
Historically, Medicare has not allowed reimbursement for telehealth services except in specific circumstances such as when the patient is located in a rural area and visits a qualifying site. During the COVID-19 pandemic, Congress waived many of the restrictions on Medicare patients receiving telehealth services in their homes and outside of rural areas. These waivers allowed patients all over the country to reap the benefits telehealth services offer. However, these waivers are scheduled to expire on September 30, 2025. Patients and providers need the security of having these restrictions permanently lifted. In particular, geographic restrictions on the location of the patient hinder many from receiving key telehealth services that would fit their needs better than an office visit. Although rural residents have obstacles to receiving in-person care, many seniors also struggle with mobility challenges, transportation restrictions, and other concerns that impede their ability to travel to a doctor’s office. Congress’ waivers of these restrictions have demonstrated that they are superfluous and obstructive to the provision of telehealth services for Medicare beneficiaries. Congress can signal their recognition of telehealth’s importance by permanently eliminating these unnecessary restrictions.
The WEAR IT Act
Wearable devices provide doctors with valuable health data, making it easier for them to assess and treat patients remotely. Telehealth has become vital in rural areas, where access to healthcare providers is often limited. But the adoption of wearable device technology has been slow in comparison to its potential impact. That’s where H.R. 4203, the Wearable Equipment Adoption Reinforcement and Investment in Technology (WEAR IT) Act comes in. WEAR IT would accelerate the wider adoption of wearable device technology, which would in turn expand the useful applications of wearables and speed up their innovation cycles. The bill would allow people to use their flexible spending accounts (FSAs) and HSAs to get reimbursed for wearable health devices and related software, as long as they are used to manage health conditions. If passed, it could help lower healthcare costs for both patients and the government.
The increased affordability of wearable health devices will not only strengthen patients’ ownership of their healthcare but also improve healthcare providers’ understanding of their patients and help them fine-tune treatment plans. Wearable health devices will also help ameliorate physician burnout by empowering patients to take charge of their healthcare and reducing office visits through remote monitoring of conditions. Congress must pass the WEAR IT Act for improved health outcomes and lower healthcare costs.
Remote Patient Monitoring Cost Sharing Elimination
One significant obstacle to the wider adoption of remote monitoring technologies is the associated cost for Medicare beneficiaries. These patients, often on a fixed income, are less able to cover the required cost sharing payments for remote monitoring services. However, these services are uniquely suited to address the conditions that plague seniors. It is estimated that 70 percent of seniors have at least one potentially disabling chronic condition, including hypertension, diabetes, and heart disease. Conditions like these require regular monitoring, and remote monitoring can make that process easier for patients and providers. For this technology to be most effective, more Medicare beneficiaries need access to it. Congress must eliminate cost sharing requirements for remote patient monitoring.
Conclusion
The OBBBA achieved several key wins for digital health, which have long been goals of CHI’s digital health advocacy. We appreciate Congress’ work in ensuring the progress continues on coverage of telemedicine and in supporting states in funding remote patient monitoring services. However, we urge continued legislation on key digital health priorities, including Medicare reimbursement for telehealth services, cost sharing elimination for remote monitoring, and the WEAR IT Act.
