PCPCC Encourages Senate to Expand Access to High-Value Preventative Care

Legislation would expand pre-deductible coverage under high-deductible plans

November 5, 2018

The Honorable Orrin G. Hatch                      The Honorable Ron Wyden
Chairman, Senate Finance Committee          Ranking Member, Senate Finance Committee
U.S. Senate                                                    U.S. Senate
219 Dirksen Senate Office Building               219 Dirksen Senate Office Building
Washington, DC 20510                                  Washington, DC 20510

Dear Chairman Hatch and Ranking Member Wyden:

The Patient-Centered Primary Care Collaborative (PCPCC) encourages the Senate to act to preserve and expand access to high-value preventative care for consumers with high-deductible healthcare plans (HDHP) coupled with health savings accounts (HSAs). PCPCC is concerned that, despite increasing access to health insurance, more consumers are skipping high-value preventative primary care – most likely due to out of pocket costs associated with high deductibles.

While there are many important steps that could be taken to address this challenge, two are currently before the 115th Congress and enjoy widespread support for inclusion this year:

  • The Chronic Disease Management Act of 2018 (H.R. 4978 / S. 2410) would allow HSA-eligible HDHPs to provide plan members access to specific high-value health care services and medications that manage chronic conditions on a pre-deductible basis.
  • First Dollar Coverage Flexibility for High Deductible Health Plans - Key provisions in Section 2 of the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 (H.R. 6199) would allow health plans to provide pre-deductible coverage of up to $250 a year for an individual and $500 a year for family.

These changes could provide meaningful flexibility for health plans to provide coverage for and incentivize the use of high-value services that can reduce health care costs more broadly, such as primary care visits and telehealth services.  Higher coverage limits should also be strongly considered, as both retain the ability of the health plan to identify and cover services that are proven to be meaningful, high-value interventions.  

Founded in 2006, the PCPCC is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations– the PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care to achieve the “Quadruple Aim”: better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

Thank you for your consideration of this important legislation. PCPCC and its multisector members look forward to working with you to enact polices which further population health and more specifically advance primary care as foundational to high-value care.  Please feel free to contact Christopher Adamec, Director of Policy at cadamec@pcpcc.org with any questions.

Sincerely,

Ann Greiner

President & CEO

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