[Congressional Record Volume 171, Number 41 (Tuesday, March 4, 2025)]
[House]
[Pages H964-H966]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHRONIC DISEASE FLEXIBLE COVERAGE ACT
Mr. SMITH of Missouri. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 919) to codify Internal Revenue Service guidance
relating to treatment of certain services and items for chronic
conditions as meeting the preventive care deductible safe harbor for
purposes of high deductible health plans in connection with health
savings accounts.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 919
Be it enacted by the Senate and House of Representatives
of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Chronic Disease Flexible
Coverage Act''.
SEC. 2. SERVICES AND ITEMS FOR CHRONIC CONDITIONS TREATED AS
PREVENTIVE CARE.
(a) In General.--The additional preventive care services
and items for chronic conditions that may be treated as
preventive care for purposes of section 223(c)(2)(C) of the
Internal Revenue Code of 1986 as set forth in IRS Notice
2019-45 shall have the same force and effect as if included
in the enactment of this Act.
(b) No Inference.--To the extent not inconsistent with
this section, no inference shall be made from subsection (a)
with respect to such other rules or guidance as the Secretary
has provided, or may provide, with respect to preventive
services for purposes of section 223(c)(2)(C) of such Code.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Missouri (Mr. Smith) and the gentleman from California (Mr. Panetta)
each will control 20 minutes.
The Chair recognizes the gentleman from Missouri.
General Leave
Mr. SMITH of Missouri. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on the bill under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Missouri?
There was no objection.
Mr. SMITH of Missouri. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of the Chronic Disease Flexible
Coverage Act, introduced by Ways and Means Health Subcommittee Chairman
Vern Buchanan and our Ways and Means colleague, Representative Jimmy
Panetta.
This legislation provides employers and their employees with greater
flexibility to design healthcare coverage options that expand access to
treatments for chronic diseases.
The chronic disease epidemic has, unfortunately, impacted nearly
every family in America and represents a significant share of our
healthcare spending. In fact, 90 percent of the $4.1 trillion this
country spends each year on healthcare goes toward chronic disease.
This is not surprising when you realize that 60 percent of Americans
suffer from some form of chronic disease, whether it be heart disease,
diabetes, or cancer.
So many Americans would benefit from having healthcare coverage that
is not only more affordable but more responsive to their needs so that
they can better manage their health.
Last Congress, the House of Representatives approved a version of
this legislation, but unfortunately, we were not able to get the bill
across the finish line. However, with President Trump back in the White
House, we are moving this bill once again, a bill that further
strengthens a policy put in place during the first Trump
administration.
For the 53 percent of employers that offer high deductible health
plans to their employees, they would now be able to improve those
options by allowing predeductible coverage of critical chronic care
management services, including beta blockers, blood pressure monitors,
glucometers, inhalers, and medications and testing to help individuals
with high cholesterol. While the bill includes 14 specific services
that could be covered, it leaves the door open for the list to be
expanded later, as well.
By providing flexible coverage options for more people living with
chronic health conditions, we can help lower their costs and improve
their health and well-being.
I thank Representatives Buchanan and Panetta for their leadership on
this issue, as well as recognize the work of our Ways and Means Health
Subcommittee that held its first hearing this Congress on creating
healthier options for families and raising awareness about the chronic
disease epidemic we have in this country.
[[Page H965]]
As HHS Secretary Kennedy is shining a light on the chronic disease
epidemic, the Ways and Means Committee is leading the charge in
Congress to examine the root causes and delivering solutions, including
this bill before us today.
I encourage all of my colleagues to once again provide strong
bipartisan support for this effort to address chronic disease. I
reserve the balance of my time.
Mr. PANETTA. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I thank the chairman of the Ways and Means Committee
and, of course, my good friend, Representative Vern Buchanan, an
excellent member of the Ways and Means Committee for their work on this
bill.
With his work, I rise today to support this legislation, the Chronic
Disease Flexible Coverage Act. This is bipartisan, commonsense
legislation to allow predeductible health coverage for chronic disease
patients with a high deductible health plan, otherwise known as HDHP.
This commonsense legislation, as you heard from the chairman, already
passed Congress last session under the leadership of my friends and
former colleagues, Brad Wenstrup and Earl Blumenauer. It is common
sense mainly because, as you heard from the chairman, chronic disease
is so common.
Mr. Speaker, 6 in 10 adult Americans have a chronic disease, which is
the leading cause of disabilities in the United States of America. Mr.
Speaker, 90 percent of our annual health spending goes to chronic
disease and mental health management. While these chronic diseases are
common, they are also manageable if we just do everything that we can
to improve access to care.
In my 19th Congressional District on the central coast of California,
the number one thing I hear about from constituents is access to
healthcare or, I should say, the lack of access to healthcare. The one
thing that is clear, though, is that insurance doesn't do you much good
if you can't use it.
In 2023, according to the Centers for Disease Control and Prevention,
more than 43 percent of people with employer-based coverage had an
HDHP. Moreover, 56 percent of employers offer an HDHP. However, nearly
59 percent of Americans--that is nearly 6 in 10 people--lack $1,000 in
savings to handle an emergency expense.
That is exactly why expanding HDHP coverage to offer critical care
for some of our most medically vulnerable constituents isn't just the
right thing to do. It is the smart thing to do.
The Chronic Disease Flexible Coverage Act codifies IRS guidance to
expand the safe harbor for high deductible health plans offering
predeductible care for chronic conditions. It lets employers offer
first-dollar access to care for patients with diabetes, asthma, high
blood pressure, and many more, as the chairman mentioned.
When this IRS guidance was originally issued in 2019, a survey found
that 76 percent, or more than three-quarters, of employers expanded
predeductible coverage for chronic diseases. Codifying this policy now
will save countless lives by helping more patients manage their
conditions and stay healthy.
That is why this bill is endorsed by so many, from chronic disease
advocates to health benefit groups to small business associations. That
is why I recommend my colleagues to vote for the Chronic Disease
Flexible Coverage Act.
Again, I thank Congressman Buchanan, and I thank the chairman for
bringing this bill forward.
Mr. Speaker, I reserve the balance of my time.
Mr. SMITH of Missouri. Mr. Speaker, I yield such time as he may
consume to the gentleman from Florida (Mr. Buchanan).
Mr. BUCHANAN. Mr. Speaker, I thank the chairman for his leadership,
as well. I rise today in strong support of my bill, the Chronic Disease
Flexible Coverage Act.
This important legislation will expand treatment options for
Americans living with chronic diseases provided through their
employer's healthcare coverage. My bill allows employers to offer
predeductibility on 14 different chronic diseases, especially for those
who are on high deductible health plans.
With 6 in 10 Americans living with at least one chronic disease, it
is clear to me that we need to have many more options. The cost for
chronic diseases in the American economy is enormous, accounting for
over $1 trillion a year, if you can imagine that. Chronic disease also
accounts for the overwhelming percentages of preventable deaths in the
United States. I believe this initiative will improve patients' health,
also reducing costly hospitalizations.
Mr. Speaker, I thank my good friend, Congressman Panetta, for his
leadership and friendship. I really appreciate his working with me on
this. I also thank Leader Scalise and Whip Emmer for bringing this to
the floor today.
I urge my colleagues to support this commonsense bill to help give
Americans the tools they need for a longer, healthier, and happier
life.
Mr. PANETTA. Mr. Speaker, I reserve the balance of my time.
Mr. SMITH of Missouri. Mr. Speaker, I yield such time as he may
consume to the gentleman from North Carolina (Mr. Murphy).
Mr. MURPHY. Mr. Speaker, we have heard from great speakers talking
about the problem with chronic disease in the United States.
One of the issues that face people who have hypertension, kidney
disease, and diabetes is that they can't get the medicines or the
devices that they need to be able to regulate their condition.
This bill, H.R. 919, helps to solve that problem by giving
individuals access to those lifesaving devices prior to them fulfilling
their deductible. This is critical, as we fight chronic disease in the
United States. As we have heard, over 90 percent of the expenditures in
this country are due to chronic disease.
I know that in my district in eastern North Carolina, the rate of
diabetes, obesity, congestive heart failure, and high blood pressure
are things that are really, truly killing our population. Being able to
access devices so that we can monitor these things is crucial. We have
to have availability for these devices for people before they have to
pay their full deductible.
I applaud Representative Buchanan, Representative Panetta, and
Chairman Smith for bringing this forward. This is common sense.
President Trump tried to do this in his first term. I am very grateful
that they are trying to do this again. We want to make America healthy
again. That starts with being able to give patients the tools that they
need to be healthy. I urge support for H.R. 919 to my colleagues.
Mr. PANETTA. Mr. Speaker, I have no further speakers, and I yield
myself the balance of my time for the purpose of closing.
Mr. Speaker, as you have heard, this legislation has bipartisan
support and support from a broad coalition of employers and health
stakeholders. I appreciate my colleagues on the other side being so
concerned and so focused on this. Let's just hope they have that same
concern when it comes to Medicaid and Medicare going forward,
especially with the reconciliation package.
They understand, and we understand, that it is critical that we start
expanding access to preventative care and chronic care management to
stem the tide of chronic disease.
Passing the Chronic Disease Flexible Coverage Act will improve long-
term health outcomes, let businesses offer superior health benefits,
and strengthen healthcare for everyone.
Once again, I encourage my colleagues to support this legislation,
and I yield back the balance of my time.
Mr. SMITH of Missouri. Mr. Speaker, I yield myself the balance of my
time for the purpose of closing.
Mr. Speaker, this legislation is long overdue, particularly given the
enormous size, scope, and cost of America's chronic disease epidemic.
It will put more patients in the driver's seat when it comes to
managing their health, and open doors for folks to get the treatments
that will not only save them money but improve their well-being.
High deductible healthcare plans are already a popular option for
employers to offer their workers. Expanding what services can be
provided under these plans, specifically to help treat chronic
diseases, will only make this a more affordable and useful health
coverage choice for patients.
I encourage my colleagues to support the passage of the Chronic
Disease Flexible Coverage Act, and I yield back the balance of my time.
[[Page H966]]
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Missouri (Mr. Smith) that the House suspend the rules
and pass the bill, H.R. 919.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
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