Expanding Pre-Deductible Telehealth Past 2024

During the COVID-19 pandemic, the government relaxed the rules to allow providers to offer telehealth services (remote health care services) without jeopardizing a health plan’s status as a high deductible health plan (HDHP).  Similarly, remote health services were available without jeopardizing individual participants’ rights to fund HSAs.  However, the relaxed rules were temporary in nature.  After 2024, pre-deductible telehealth services will no longer be available for HDHP participants.  Recent proposals have been made to extend and expand the availability of pre-deductible telehealth services.

We asked two professors and authors of ALM’s Tax Facts with opposing political viewpoints to share their opinions about whether pre-deductible telehealth services should be permitted past the 2024 tax year.

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

Their Votes:





Bloink: Without fast Congressional action, the cost of telehealth services is sure to rise sharply just next month.  Steep costs obviously mean that countless Americans will no longer have access to remote health services—and may fail to seek medical attention at all.  We shouldn’t want Americans to wait until conditions are severe enough to visit an emergency room.  That increases the cost of health care across the board, even for those with more comprehensive health insurance coverage.

Byrnes: While telehealth services do have their place, expanding the pre-deductible coverage rules for HDHP plan participants shouldn't be a priority.  In reality, we should be focused on reducing the cost of health coverage in general.  Singling out the HDHP plan for preferred access to telehealth coverage isn’t going to make a significant dent in the cost of health coverage for ordinary Americans.  We have to look at the big picture here.

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Bloink: Telehealth services are incredibly valuable to taxpayers who can't easily get to a physical medical facility.  Countless Americans are living in so-called "healthcare deserts", where access to physical healthcare services is difficult to find.  We should be doing everything we can to ensure that every American has access to the health services they need.  We have the technology, so there’s no reason why remote healthcare shouldn’t be promoted for individuals who are currently struggling with high deductibles under HDHPs.

Byrnes: Employees with HDHPs have access to a valuable tax-preferred savings option: the health savings account.  That alone reduces the cost of their health coverage.  Yes, remote health services have their place—and were incredibly valuable during the pandemic, when many Americans would have risked their health by visiting a doctor in person.  That doesn’t mean we continue to extend pandemic-era breaks indefinitely.

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Bloink: Remote healthcare is also critical to providing mental health services to individuals who would otherwise fail to seek out the help they need.  Something like 80 of all American employers intend to provide employees with access to mental health services via telehealth in 2025.  Allowing these services to be provided on a pre-deductible basis is incredibly valuable.  Without the extension--or even making pre-deductible telehealth permanent--employees will surely face higher costs, which will create a barrier to accessing needed services.

Byrnes: Americans are fully able to access medical care in-person.  An in-person medical examination is much more likely to uncover the root cause of a patient's concerns.  Telehealth simply cannot provide an effective substitute for a hands-on medical examination.  While travel may be necessary for some Americans to access the quality healthcare they need, we have to weigh the benefits of that quality in-person medical care against the burden of requiring them to leave their homes.