With costs increasing on everything from food, energy, housing, travel, and medical care, it is a good time to consider healthcare policies that would help reduce costs and improve care at the same time. Health savings accounts came on the scene about 20 years ago and while they’ve been responsible for some important improvements in our healthcare system, it is time for some refinements and improvements to allow important innovations in healthcare to move forward.
Putting the patient-doctor relationship at the center of healthcare reforms makes a lot of sense. Yet, far too often, government seems to want to make bureaucrats the focal point of healthcare. Direct primary care is growing in popularity because it puts the patient-doctor relationship at the epicenter of healthcare delivery. It provides the patient with quality primary, preventive, and chronic care at a flat fee without the hassles of mounds of paperwork or insurance forms, or unpredictable costs. This direct care model works because it provides care outside of the typical fee for service billing. Instead, the patient (or the patient’s employer) has a direct agreement for medical services with a primary care provider.
Employers who want to save money and attract qualified employees with these high quality benefits incorporate employer-sponsored, value-based healthcare services into their health plan offerings. A number of innovative pilot plans have been provided by large employers so that their employees have significant added benefits. The employees receive a traditional insurance plan, but on top of that — at no cost to them — employees have the option to enroll in a direct primary care arrangement which gives them access to integrated mental health resources, same or next day appointments, and guidance on how to most effectively navigate the healthcare system when specialty care is needed.
But as successful and popular as such direct primary care arrangements have become, current IRS rules limit the ability of employers to innovate and provide additional healthcare savings plans that are proving very popular with employees. Current rules significantly limit the number of employees who can have a direct primary care provider. This is precisely why the current law needs to be updated.
The Primary Care Enhancement Act is bi-partisan legislation that would remove the existing roadblock so that more Americans can have access to affordable primary care. This needed reform would allow employers to more widely offer direct primary care as part of their health benefits and for employees to choose them. Because direct primary care did not exist as a healthcare delivery model at the time that Healthcare Savings Accounts were created in the federal code, it is time to make sure our laws and regulations don’t block this important innovation.
Employers like investing in preventative and primary care because it improves the health and productivity of their workforce. It also lowers other healthcare costs because it reduces expensive and emergency care needs by providing effective early intervention.
Employees like direct primary care because it allows them to focus on the patient-doctor relationship in the mental and physical healthcare arena. It is also typically easier to schedule same day or next day visits with one’s doctor. There are no worries about insurance paperwork or bills. And perhaps most importantly, employees see improved healthcare outcomes.
All of this highlights the need to update and reform the current law because as much as employers and employees both want to have the direct primary care option, the tax code hasn’t kept pace with the innovations available, so employers cannot offer it to their employees who have an HSA.
The Primary Care Enhancement Act has been introduced to clarify that direct primary care arrangements are permissible with HSA plans. It would also allow those with HSAs to pay for direct primary care with those savings. This legislation isn’t new, it has been reviewed and carefully examined over the last four Congresses. The legislation has passed in the Ways & Means Committee three times on a bipartisan basis. Most recently, earlier this Fall, it was favorably reported out of the Committee on a vote of 28-14.
The Primary Care Enhancement Act is a real opportunity for the GOP to get an important healthcare win for patients in an important election year. And waiting for the next Congress to pass this means delaying for another year the ability of Americans to lower their healthcare costs and improve the quality of their care at once. Moreover, waiting could endanger its passage because a strong Democrat supporter of the legislation, Rep. Earl Blumenauer (D-Ore.), has announced his retirement. So the time is now. Americans need access to this important innovation and politically, it makes zero sense to wait. Helping Americans and their families obtain quality and affordable healthcare as soon as possible should be a high priority.
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