“On Tuesday, June 6, the U.S. House of Representatives’ Education & Workforce Committee will consider a bill, H.R. 824, that would encourage the proliferation of telehealth coverage as a standalone employee benefit,” Sabrina Corlette and Rachel Schwab of the Georgetown Center for Health Insurance Reforms write, in an article headlined “A Wolf in Sheep’s Clothing.” “Proponents of this legislation — many of whom stand to profit from the sale of these products — argue that it would give employers and workers more affordable options. However, under the proposed legislation, standalone telehealth products would be almost entirely exempt from regulatory oversight, posing significant risks to consumers who could face deceptive marketing of these arrangements as a substitute for comprehensive coverage. The delivery of health care services via telehealth modalities expanded dramatically during the COVID-19 pandemic. … Designating telehealth coverage as an excepted benefit is thus unlikely to expand workers’ access to these services. Instead, the proposal poses several problems for workers and their families. … First, separating telehealth services from employees’ health benefits fractures care delivery and frustrates the coordination of care for patients, who will likely have to see a different provider than their usual source of care to access covered telehealth benefits. … Second, designating telehealth coverage as an excepted benefit puts consumers at risk by encouraging the marketing of products that are exempt from critical federal protections. A telehealth insurer could charge a higher premium to someone with a pre-existing condition. … Third, excepted benefits have a troubled history, with vendors often deceptively marketing these products as an alternative to comprehensive health insurance. … Fourth, a standalone telehealth benefit that an employee can choose in lieu of a major medical plan could disproportionately harm lower income workers. These workers may be encouraged to enroll in the telehealth benefit, potentially packaged with another excepted benefit such as a fixed indemnity policy, as an affordable alternative to their employer’s major medical plan. Thus, while H.R. 824 is touted as expanding telehealth coverage, its main effect would instead be to silo medical services delivered through video and audio modalities from the rest of the care delivery system, increase the potential for scams and deceptive marketing, and expose workers and their dependents to health and financial risk by rolling back critical consumer protections.
