How the One Big Beautiful Bill will impact telehealth coverage for HDHPs

With the passage of the One Big Beautiful Bill Act, Congress has made permanent the safe harbor allowing high-deductible health plans (HDHPs) to cover telehealth and other remote services before the deductible is met.

It may seem like a small technical change in a bill with other large implications for healthcare in the country, but it creates real, practical opportunity, especially for those dealing with high-cost health issues, such as cancer care. As a result, leaders should be rethinking their benefit plans. 

With this safe harbor in place, employers now have the ability to change access, availability, and utilization of critical health services — especially for those with the highest financial and geographic barriers to care.

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About 50% of private-sector employees are enrolled in HDHPs, with median deductibles around $2,750. That's a meaningful share of household savings (median: $8,000), and for many, it exceeds what they have available.

We also know that cost-sharing reduces care-seeking, particularly for preventive services. People delay or skip screenings, risk assessments, and follow-up care. This isn't because they don't need them, but because they can't afford them upfront.

That includes many who are:

• Less likely to engage with the health system early, and therefore more likely to delay care
• More likely to become high-cost claimants due to late-stage diagnosis or avoidable complications
• More likely to reside in rural areas — rural employees are more likely to elect HDHP options than their urban counterparts — where healthcare access has been worsening over the last decade, especially cancer care

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As cancer rates are rising in younger populations, we now have the infrastructure to deliver high-impact (on outcomes and costs) parts of cancer care services virtually, without requiring in-person visits. This includes services like risk assessments, screening, diagnostic follow-ups to screening, nutrition consults for those in treatment, symptom checks and more. 

This small policy change has effectively created a significant opportunity for a lot more low-cost access for employees in HDHPs, and ensures employers can actually consistently roll out a cancer care strategy across their full employee population on their plans. 

Virtual care models are also more cost effective to employers and the system: no brick-and-mortar facility costs, productivity savings for employees not having to travel/take time off work; more efficient clinical visits; etc. 

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Telehealth-enabled cancer care isn't a stopgap. It's a practical, scalable approach that employers can use to take control of cancer with more available, utilized and cost-effective care. 

The policy is now permanent. The opportunity is in how we choose to use it.