[House Report 118-109]
[From the U.S. Government Publishing Office]


118th Congress    }                                     {    Report
                         HOUSE OF REPRESENTATIVES
 1st Session      }                                     {    118-109

======================================================================



 
                    TELEHEALTH EXPANSION ACT OF 2023

                                _______
                                

 June 13, 2023.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Smith of Missouri, from the Committee on Ways and Means, submitted 
                             the following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 1843]

    The Committee on Ways and Means, to whom was referred the 
bill (H.R. 1843) to amend the Internal Revenue Code of 1986 to 
permanently extend the exemption for telehealth services from 
certain high deductible health plan rules, having considered 
the same, reports favorably thereon with an amendment and 
recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. SUMMARY AND BACKGROUND...........................................2
          A. Purpose and Summary.................................     2
          B. Background and Need for Legislation.................     2
          C. Legislative History.................................     2
          D. Legislative History.................................     3
 II. EXPLANATION OF THE BILL..........................................3
          A. Making Permanent the Safe Harbor for Absence of 
              Deductible for Telehealth (sec. 2 of the bill and 
              sec. 223 of the Code)..............................     3
III. VOTE OF THE COMMITTEE............................................5
 IV. BUDGET EFFECTS OF THE BILL.......................................6
          A. Committee Estimate of Budgetary Effects.............     6
          B. Statement Regarding New Budget Authority and Tax 
              Expenditures Budget Authority......................     6
          C. Cost Estimate Prepared by the Congressional Budget 
              Office.............................................     6
  V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE.......6
          A. Committee Oversight Findings and Recommendations....     6
          B. Statement of General Performance Goals and 
              Objectives.........................................     6
          C. Information Relating to Unfunded Mandates...........     6
          D. Congressional Earmarks, Limited Tax Benefits, and 
              Limited Tariff Benefits............................     7
          E. Tax Complexity Analysis.............................     7
          F. Duplication of Federal Programs.....................     7
 VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED............7
          A. Changes in Existing Law Proposed by the Bill, as 
              Reported...........................................     7
VII. DISSENTING VIEWS................................................18

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Telehealth Expansion Act of 2023''.

SEC. 2. MAKING PERMANENT THE SAFE HARBOR FOR ABSENCE OF DEDUCTIBLE FOR 
                    TELEHEALTH.

  (a) In General.--Section 223(c)(2)(E) of the Internal Revenue Code of 
1986 is amended by striking ``In the case of'' and all that follows 
through ``a plan'' and inserting ``A plan''.
  (b) Certain Coverage Disregarded.--Section 223(c)(1)(B)(ii) of the 
Internal Revenue Code of 1986 is amended by striking ``(in the case of 
months or plan years to which paragraph (2)(E) applies)''.
  (c) Effective Date.--The amendments made by this section shall apply 
to plan years beginning after December 31, 2024.

                       I. SUMMARY AND BACKGROUND


                         A. Purpose and Summary

    The bill, H.R. 1843, the ``Telehealth Expansion Act of 
2023,'' as ordered reported by the Committee on Ways and Means 
on June 7, 2023, to permanently extend the safe harbor that 
allows employers who offer High Deductible Health Plans (HDHP) 
paired with a Health Savings Account (HSA) to allow for the 
absence of a deductible for telehealth.

                 B. Background and Need for Legislation

    In order for an individual with a HDHP to make or receive 
contributions to a HSA, an individual cannot have disqualifying 
health coverage. An HDHP is a health insurance plan that 
satisfies certain requirements with respect to minimum 
deductibles and maximum out-of-pocket expenses. Generally, 
under section 223(c)(2)(A) of the Internal Revenue Code, a HDHP 
may not provide benefits for any year until the minimum 
deductible for that year is satisfied. In the Coronavirus Aid, 
Relief, and Economic Security Act (CARES Act, PL 116-136) 
Congress established a safe harbor for the absence of a 
deductible for telehealth for plan years beginning on or before 
December 31, 2021. This flexibility was subsequentially 
extended in the Consolidated Appropriations Act of 2022 (PL 
117-103) and the Consolidated Appropriations Act of 2023 (PL 
117-328). This safe harbor is set to expire for plan years 
beginning after January 1, 2025. The Committee believes that 
this legislation is needed to permanently extend the ability 
for employees who are enrolled in HDHPs paired with an HSA to 
utilize first dollar coverage for telehealth services.

                         C. Legislative History


Background

    H.R. 1843 was introduced on March 28, 2023, and was 
referred to the Committee on Ways and Means.

Committee hearings

    On Tuesday, March 23, 2023, the Committee held a Full 
Committee Hearing on ``Why Health Care is Unaffordable: The 
Fallout of Democrats'' Inflation on Patients and Small 
Businesses''.

Committee action

    The Committee on Ways and Means marked up H.R. 1843, the 
``Telehealth Expansion Act of 2023,'' on June 7, 2023, and 
ordered the bill, as amended, favorably reported (with a quorum 
being present).

                         D. Legislative History

    Pursuant to clause 3(c)(6) of rule XIII, the following 
hearings were used to develop and consider H.R. 1843:
    (1) Committee on Ways and Means Full Committee Hearing 
``Why Health Care is Unaffordable: The Fallout of Democrats'' 
Inflation on Patients and Small Businesses''.

                      II. EXPLANATION OF THE BILL


   A. Making Permanent the Safe Harbor for Absence of Deductible for 
        Telehealth (sec. 2 of the bill and sec. 223 of the Code)


                              PRESENT LAW

Health savings accounts

    An individual may contribute to a health savings account 
(``HSA'') only if the individual is covered under a plan that 
meets the requirements for a high deductible health plan, as 
described below. An HSA is a tax-exempt trust or custodial 
account created exclusively to pay for the qualified medical 
expenses of the account holder and his or her spouse and 
dependents.\1\ The HSA rules allow deductible contributions to, 
and tax-exempt distributions from, HSAs for current medical 
expenses as well as an income tax exemption for earnings on HSA 
investments to be used for future medical expenses.
---------------------------------------------------------------------------
    \1\Sec. 223(d).
---------------------------------------------------------------------------
    Within limits,\2\ an eligible individual is allowed a 
deduction for contributions to an HSA made by or on behalf of 
the individual.\3\ Contributions to an HSA are excludible from 
an individual's income and from employment taxes if made by 
theindividual's employer. Earnings in HSAs are not taxable.\4\ 
Distributions from an HSA for qualified medical expenses are 
not includible in the HSA beneficiary's gross income.\5\ 
Distributions from an HSA that are not used for qualified 
medical expenses are includible in the HSA beneficiary's gross 
income and are subject to an additional tax of 20 percent.\6\ 
The 20-percent additional tax does not apply if the 
distribution is made after the beneficiary dies, becomes 
disabled, or attains the age of Medicare eligibility (age 
65).\7\
---------------------------------------------------------------------------
    \2\For 2023, the basic limit on annual contributions that can be 
made to an HSA is $3,850 in the case of self-only coverage and $7,750 
in the case of family coverage. Rev. Proc. 2022-24, 2022-20 I.R.B. 
1075. The basic annual contributions limits are increased by $1,000 for 
individuals who have attained age 55 by the end of the taxable year 
(referred to as ``catch-up'' contributions). Sec. 223(b)(3).
    \3\A family member (or any other person) may make contributions to 
an HSA on behalf of an eligible individual. See Notice 2004-50, Q & A 
38, 2003-33, I.R.B. 196 (August 9, 2004).
    \4\Sec. 223(e).
    \5\Sec. 223(f)(1).
    \6\Sec. 223(f)(2), (4).
    \7\Sec. 223(f)(4).
---------------------------------------------------------------------------

High deductible health plans

    A high deductible health plan (``HDHP'') is a health plan 
that has an annual deductible of at least $1,500 (for 2023) for 
self-only coverage and twice this amount for family coverage 
($3,000 for 2023), and for which the sum of the annual 
deductible and other annual out-of-pocket expenses (other than 
premiums) for covered benefits does not exceed $7,500 (for 
2023) for self-only coverage and twice this amount for family 
coverage ($15,000 for 2023).\8\ These dollar thresholds are 
adjusted for inflation.\9\
---------------------------------------------------------------------------
    \8\ Sec. 223(c)(2).
    \9\ Sec. 223(g).
---------------------------------------------------------------------------
    An individual who is covered under an HDHP is eligible to 
contribute to an HSA if the individual is not also covered 
under a non-HDHP that provides coverage for any benefit 
(subject to certain exceptions) that is covered under the 
HDHP.\10\
---------------------------------------------------------------------------
    \10\Sec. 223(c)(1).
---------------------------------------------------------------------------
    Various types of coverage are disregarded for this purpose, 
including coverage of any benefit provided by permitted 
insurance, coverage (whether through insurance or otherwise) 
for accidents, disability, dental care, vision care, or long-
term care, as well as certain limited coverage through health 
flexible spending arrangements.\11\ Permitted insurance means 
insurance under which substantially all of the coverage 
provided relates to liabilities incurred under workers' 
compensation laws, tort liabilities, liabilities relating to 
ownership or use of property, or such other similar liabilities 
as specified by the Secretary of the Treasury under 
regulations. Permitted insurance also means insurance for a 
specified disease or illness, and insurance paying a fixed 
amount per day (or other period) of hospitalization.\12\
---------------------------------------------------------------------------
    \11\Sec. 223(c)(1)(B).
    \12\Sec. 223(c)(3).
---------------------------------------------------------------------------
    A plan does not fail to qualify as an HDHP by reason of 
failing to have a deductible for preventive care.\13\
---------------------------------------------------------------------------
    \13\Sec. 223(c)(2)(C).
---------------------------------------------------------------------------
    For plan years beginning on or before December 31, 2021, an 
HDHP is permitted to cover telehealth and other remote care 
services without satisfaction of the plan's minimum 
deductible.\14\ Thus, a health plan does not fail to be treated 
as an HDHP merely by reason of failing to require a deductible 
for telehealth and other remote care services for plan years 
beginning on or before December 31, 2021, and an individual who 
is covered under such a plan may contribute to an HSA.\15\ 
Section 307 of Division P of the Consolidated Appropriations 
Act, 2022 extended the exemption for telehealth services to 
include months beginning after March 31, 2022, and before 
January 1, 2023.\16\ Finally, Section 4151 of Division FF of 
the Consolidated Appropriations Act, 2023, extended the 
exemption for telehealth services to include plan years 
beginning after December 31, 2022, and before January 1, 
2025.\17\
---------------------------------------------------------------------------
    \14\CARES Act, Pub. L. No. 116-136, sec. 3701, March 27, 2020.
    \15\Notice 2020-29, 2020-22 I.R.B. 864, provides that this standard 
applies with respect to services provided on or after January 1, 2020.
    \16\Pub. L. No. 117-103, March 15, 2022.
    \17\Pub. L. No. 117-328, December 29, 2022.
---------------------------------------------------------------------------

                           REASONS FOR CHANGE

    The Committee observes that many individuals who have 
coverage under an HDHP, especially working parents and 
individuals living in rural areas, rely on telehealth and other 
remote care services for their medical care. The Committee also 
notes that telehealth has made it easier for individuals who 
have HDHP coverage to receive timely medical care and avoid 
future medical complications. The provision is intended to 
preserve access to telehealth and other remote care services 
for individuals with HDHP coverage.

                        EXPLANATION OF PROVISION

    The provision provides a permanent safe harbor under which 
a plan does not fail to be treated as an HDHP merely by reason 
of providing, without satisfaction of the plan's deductible, 
telehealth and other remote care services.

                             EFFECTIVE DATE

    The provision applies to plan years beginning after 
December 31, 2024.

                       III. VOTE OF THE COMMITTEE

    Pursuant to clause 3(b) of rule XIII of the Rules of the 
House of Representatives, the following statement is made 
concerning the vote of the Committee on Ways and Means in its 
consideration of H.R. 1843, the ``Telehealth Expansion Act of 
2023,'' on June 7, 2023.
    The bill, H.R. 1843, the ``Telehealth Expansion Act of 
2023,'' as amended, was ordered favorably reported to the House 
of Representatives as amended by a roll call vote of 30 yeas to 
12 nays (with a quorum being present).

----------------------------------------------------------------------------------------------------------------
          Representative             Yea      Nay     Present      Representative      Yea      Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Smith (MO)...................       X   .......  .........  Mr. Neal...........  .......       X   .........
Mr. Buchanan.....................       X   .......  .........  Mr. Doggett........  .......       X   .........
Mr. Smith (NE)...................       X   .......  .........  Mr. Thompson.......       X   .......  .........
Mr. Kelly........................       X   .......  .........  Mr. Larson.........  .......       X   .........
Mr. Schweikert...................       X   .......  .........  Mr. Blumenauer.....  .......       X   .........
Mr. LaHood.......................       X   .......  .........  Mr. Pascrell.......  .......       X   .........
Dr. Wenstrup.....................       X   .......  .........  Mr. Davis..........  .......       X   .........
Mr. Arrington....................       X   .......  .........  Ms. Sanchez........  .......  .......  .........
Dr. Ferguson.....................       X   .......  .........  Mr. Higgins........  .......       X   .........
Mr. Estes........................       X   .......  .........  Ms. Sewell.........       X   .......  .........
Mr. Smucker......................       X   .......  .........  Ms. DelBene........       X   .......  .........
Mr. Hern.........................       X   .......  .........  Ms. Chu............  .......       X   .........
Ms. Miller.......................       X   .......  .........  Ms. Moore..........  .......       X   .........
Dr. Murphy.......................       X   .......  .........  Mr. Kildee.........  .......       X   .........
Mr. Kustoff......................       X   .......  .........  Mr. Beyer..........  .......       X   .........
Mr. Fitzpatrick..................       X   .......  .........  Mr. Evans..........  .......       X   .........
Mr. Steube.......................       X   .......  .........  Mr. Schneider......       X   .......  .........
Ms. Tenney.......................       X   .......  .........  Mr. Panetta........       X   .......  .........
Mrs. Fischbach...................       X   .......  .........
Mr. Moore........................       X   .......  .........
Mrs. Steel.......................       X   .......  .........
Ms. Van Duyne....................       X   .......  .........
Mr. Feenstra.....................       X   .......  .........
Ms. Malliotakis..................       X   .......  .........
Mr. Carey........................       X   .......  .........
----------------------------------------------------------------------------------------------------------------

                     IV. BUDGET EFFECTS OF THE BILL


               A. Committee Estimate of Budgetary Effects

    In compliance with clause 3(d) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the effects on the budget of the bill, H.R. 1843, as 
reported. The estimate prepared by the Congressional Budget 
Office (CBO) is included below.
    The bill is estimated to decrease Federal fiscal year 
budget receipts by $5.1 billion for the period 2023 through 
2033.

B. Statement Regarding New Budget Authority and Tax Expenditures Budget 
                               Authority

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee states that the 
bill involves no new or increased budget authority.

                   C. Cost Estimate Prepared by the 
                      Congressional Budget Office

    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

     V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE


          A. Committee Oversight Findings and Recommendations

    With respect to clause 3(c)(1) of rule XIII of the Rules of 
the House of Representatives, the Committee made findings and 
recommendations that are reflected in this report.

        B. Statement of General Performance Goals and Objectives

    With respect to clause 3(c)(4) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
bill does not authorize funding, so no statement of general 
performance goals and objectives is required.

              C. Information Relating to Unfunded Mandates

    This information is provided in accordance with section 423 
of the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104-
4).
    The Committee has determined that the bill does not contain 
Federal mandates on the private sector. The Committee has 
determined that the bill does not impose a Federal 
intergovernmental mandate on State, local, or tribal 
governments.

  D. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff 
                                Benefits

    With respect to clause 9 of rule XXI of the Rules of the 
House of Representatives, the Committee has carefully reviewed 
the provisions of the bill, and states that the provisions of 
the bill do not contain any congressional earmarks, limited tax 
benefits, or limited tariff benefits within the meaning of the 
rule.

                       E. Tax Complexity Analysis

    Pursuant to clause 3(h)(1) of rule XIII of the Rules of the 
House of Representatives, the staff of the Joint Committee on 
Taxation has determined that a complexity analysis is not 
required under section 4022(b) of the IRS Reform Act because 
the bill contains no provisions that amend the Internal Revenue 
Code of 1986 and that have ``widespread applicability'' to 
individuals or small businesses, within the meaning of the 
rule.

                   F. Duplication of Federal Programs

    In compliance with clause 3(c)(5) of rule XIII of the Rules 
of the House of Representatives, the Committee states that no 
provision of the bill establishes or reauthorizes: (1) a 
program of the Federal Government known to be duplicative of 
another Federal program; (2) a program included in any report 
from the Government Accountability Office to Congress pursuant 
to section 21 of Public Law 111-139; or (3) a program related 
to a program identified in the most recent Catalog of Federal 
Domestic Assistance, published pursuant to the Federal Program 
Information Act (Pub. L. No. 95-220, as amended by Pub. L. No. 
98-169).

             VI. CHANGES IN EXISTING LAW MADE BY THE BILL, 
                              AS REPORTED


      A. Changes in Existing Law Proposed by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

                     INTERNAL REVENUE CODE OF 1986




           *       *       *       *       *       *       *
Subtitle A--Income Taxes

           *       *       *       *       *       *       *


CHAPTER 1--NORMAL TAXES AND SURTAXES

           *       *       *       *       *       *       *


Subchapter B--COMPUTATION OF TAXABLE INCOME

           *       *       *       *       *       *       *


PART VII--ADDITIONAL ITEMIZED DEDUCTIONS FOR INDIVIDUALS

           *       *       *       *       *       *       *



SEC. 223. HEALTH SAVINGS ACCOUNTS.

  (a) Deduction allowed.--In the case of an individual who is 
an eligible individual for any month during the taxable year, 
there shall be allowed as a deduction for the taxable year an 
amount equal to the aggregate amount paid in cash during such 
taxable year by or on behalf of such individual to a health 
savings account of such individual.
  (b) Limitations.--
          (1) In general.--The amount allowable as a deduction 
        under subsection (a) to an individual for the taxable 
        year shall not exceed the sum of the monthly 
        limitations for months during such taxable year that 
        the individual is an eligible individual.
          (2) Monthly limitation.--The monthly limitation for 
        any month is 1/12 of--
                  (A) in the case of an eligible individual who 
                has self-only coverage under a high deductible 
                health plan as of the first day of such month, 
                $2,250.
                  (B) in the case of an eligible individual who 
                has family coverage under a high deductible 
                health plan as of the first day of such month, 
                $4,500.
          (3) Additional contributions for individuals 55 or 
        older.--
                  (A) In general.--In the case of an individual 
                who has attained age 55 before the close of the 
                taxable year, the applicable limitation under 
                subparagraphs (A) and (B) of paragraph (2) 
                shall be increased by the additional 
                contribution amount.
                  (B) Additional contribution amount.--For 
                purposes of this section, the additional 
                contribution amount is the amount determined in 
                accordance with the following table:
          (4) Coordination with other contributions.--The 
        limitation which would (but for this paragraph) apply 
        under this subsection to an individual for any taxable 
        year shall be reduced (but not below zero) by the sum 
        of--
                  (A) the aggregate amount paid for such 
                taxable year to Archer MSAs of such individual,
                  (B) the aggregate amount contributed to 
                health savings accounts of such individual 
                which is excludable from the taxpayer's gross 
                income for such taxable year under section 
                106(d) (and such amount shall not be allowed as 
                a deduction under subsection (a)), and
                  (C) the aggregate amount contributed to 
                health savings accounts of such individual for 
                such taxable year under section 408(d)(9) (and 
                such amount shall not be allowed as a deduction 
                under subsection (a)).
        Subparagraph (A) shall not apply with respect to any 
        individual to whom paragraph (5) applies.
          (5) Special rule for married individuals.--In the 
        case of individuals who are married to each other, if 
        either spouse has family coverage--
                  (A) both spouses shall be treated as having 
                only such family coverage (and if such spouses 
                each have family coverage under different 
                plans, as having the family coverage with the 
                lowest annual deductible), and
                  (B) the limitation under paragraph (1) (after 
                the application of subparagraph (A) and without 
                regard to any additional contribution amount 
                under paragraph (3))--
                          (i) shall be reduced by the aggregate 
                        amount paid to Archer MSAs of such 
                        spouses for the taxable year, and
                          (ii) after such reduction, shall be 
                        divided equally between them unless 
                        they agree on a different division.
          (6) Denial of deduction to dependents.--No deduction 
        shall be allowed under this section to any individual 
        with respect to whom a deduction under section 151 is 
        allowable to another taxpayer for a taxable year 
        beginning in the calendar year in which such 
        individual's taxable year begins.
          (7) Medicare eligible individuals.--The limitation 
        under this subsection for any month with respect to an 
        individual shall be zero for the first month such 
        individual is entitled to benefits under title XVIII of 
        the Social Security Act and for each month thereafter.
          (8) Increase in limit for individuals becoming 
        eligible individuals after the beginning of the year.--
                  (A) In general.--For purposes of computing 
                the limitation under paragraph (1) for any 
                taxable year, an individual who is an eligible 
                individual during the last month of such 
                taxable year shall be treated--
                          (i) as having been an eligible 
                        individual during each of the months in 
                        such taxable year, and
                          (ii) as having been enrolled, during 
                        each of the months such individual is 
                        treated as an eligible individual 
                        solely by reason of clause (i), in the 
                        same high deductible health plan in 
                        which the individual was enrolled for 
                        the last month of such taxable year.
                  (B) Failure to maintain high deductible 
                health plan coverage.--
                          (i) In general.--If, at any time 
                        during the testing period, the 
                        individual is not an eligible 
                        individual, then--
                                  (I) gross income of the 
                                individual for the taxable year 
                                in which occurs the first month 
                                in the testing period for which 
                                such individual is not an 
                                eligible individual is 
                                increased by the aggregate 
                                amount of all contributions to 
                                the health savings account of 
                                the individual which could not 
                                have been made but for 
                                subparagraph (A), and
                                  (II) the tax imposed by this 
                                chapter for any taxable year on 
                                the individual shall be 
                                increased by 10 percent of the 
                                amount of such increase.
                          (ii) Exception for disability or 
                        death.--Subclauses (I) and (II) of 
                        clause (i) shall not apply if the 
                        individual ceased to be an eligible 
                        individual by reason of the death of 
                        the individual or the individual 
                        becoming disabled (within the meaning 
                        of section 72(m)(7)).
                          (iii) Testing period.--The term 
                        ``testing period'' means the period 
                        beginning with the last month of the 
                        taxable year referred to in 
                        subparagraph (A) and ending on the last 
                        day of the 12th month following such 
                        month.
  (c) Definitions and special rules.--For purposes of this 
section--
          (1) Eligible individual.--
                  (A) In general.--The term ``eligible 
                individual'' means, with respect to any month, 
                any individual if--
                          (i) such individual is covered under 
                        a high deductible health plan as of the 
                        1st day of such month, and
                          (ii) such individual is not, while 
                        covered under a high deductible health 
                        plan, covered under any health plan--
                                  (I) which is not a high 
                                deductible health plan, and
                                  (II) which provides coverage 
                                for any benefit which is 
                                covered under the high 
                                deductible health plan.
                  (B) Certain coverage disregarded.--
                Subparagraph (A)(ii) shall be applied without 
                regard to--
                          (i) coverage for any benefit provided 
                        by permitted insurance,
                          (ii) coverage (whether through 
                        insurance or otherwise) for accidents, 
                        disability, dental care, vision care, 
                        long-term care, or [(in the case of 
                        months or plan years to which paragraph 
                        (2)(E) applies)] telehealth and other 
                        remote care, and
                          (iii) for taxable years beginning 
                        after December 31, 2006, coverage under 
                        a health flexible spending arrangement 
                        during any period immediately following 
                        the end of a plan year of such 
                        arrangement during which unused 
                        benefits or contributions remaining at 
                        the end of such plan year may be paid 
                        or reimbursed to plan participants for 
                        qualified benefit expenses incurred 
                        during such period if--
                                  (I) the balance in such 
                                arrangement at the end of such 
                                plan year is zero, or
                                  (II) the individual is making 
                                a qualified HSA distribution 
                                (as defined in section 106(e)) 
                                in an amount equal to the 
                                remaining balance in such 
                                arrangement as of the end of 
                                such plan year, in accordance 
                                with rules prescribed by the 
                                Secretary.
                  (C) Special rule for individuals eligible for 
                certain veterans benefits.--An individual shall 
                not fail to be treated as an eligible 
                individual for any period merely because the 
                individual receives hospital care or medical 
                services under any law administered by the 
                Secretary of Veterans Affairs for a service-
                connected disability (within the meaning of 
                section 101(16) of title 38, United States 
                Code).
                  (D) Special rule for individuals receiving 
                benefits subject to surprise billing 
                statutes.--An individual shall not fail to be 
                treated as an eligible individual for any 
                period merely because the individual receives 
                benefits for medical care subject to and in 
                accordance with section 9816 or 9817, section 
                2799A-1 or 2799A-2 of the Public Health Service 
                Act, or section 716 or 717 of the Employee 
                Retirement Income Security Act of 1974, or any 
                State law providing similar protections to such 
                individual.
          (2) High deductible health plan.--
                  (A) In general.--The term ``high deductible 
                health plan'' means a health plan--
                          (i) which has an annual deductible 
                        which is not less than--
                                  (I) $1,000 for self-only 
                                coverage, and
                                  (II) twice the dollar amount 
                                in subclause (I) for family 
                                coverage, and
                          (ii) the sum of the annual deductible 
                        and the other annual out-of-pocket 
                        expenses required to be paid under the 
                        plan (other than for premiums) for 
                        covered benefits does not exceed--
                                  (I) $5,000 for self-only 
                                coverage, and
                                  (II) twice the dollar amount 
                                in subclause (I) for family 
                                coverage.
                  (B) Exclusion of certain plans.--Such term 
                does not include a health plan if substantially 
                all of its coverage is coverage described in 
                paragraph (1)(B).
                  (C) Safe harbor for absence of preventive 
                care deductible.--A plan shall not fail to be 
                treated as a high deductible health plan by 
                reason of failing to have a deductible for 
                preventive care (within the meaning of section 
                1861 of the Social Security Act, except as 
                otherwise provided by the Secretary).
                  (D) Special rules for network plans.--In the 
                case of a plan using a network of providers--
                          (i) Annual out-of-pocket 
                        limitation.--Such plan shall not fail 
                        to be treated as a high deductible 
                        health plan by reason of having an out-
                        of-pocket limitation for services 
                        provided outside of such network which 
                        exceeds the applicable limitation under 
                        subparagraph (A)(ii).
                          (ii) Annual deductible.--Such plan's 
                        annual deductible for services provided 
                        outside of such network shall not be 
                        taken into account for purposes of 
                        subsection (b)(2).
                  (E) Safe harbor for absence of deductible for 
                telehealth.--[In the case of--]
                          [(i) months beginning after March 31, 
                        2022, and before January 1, 2023, and
                          [(ii) plan years beginning on or 
                        before December 31, 2021, or after 
                        December 31, 2022, and before January 
                        1, 2025,
                 a plan] A plan  shall not fail to be treated 
                as a high deductible health plan by reason of 
                failing to have a deductible for telehealth and 
                other remote care services.
                  (F) Special rule for surprise billing.--A 
                plan shall not fail to be treated as a high 
                deductible health plan by reason of providing 
                benefits for medical care in accordance with 
                section 9816 or 9817, section 2799A-1 or 2799A-
                2 of the Public Health Service Act, or section 
                716 or 717 of the Employee Retirement Income 
                Security Act of 1974, or any State law 
                providing similar protections to individuals, 
                prior to the satisfaction of the deductible 
                under paragraph (2)(A)(i).
                  (G) Safe harbor for absence of deductible for 
                certain insulin products.--
                          (i) In general.--A plan shall not 
                        fail to be treated as a high deductible 
                        health plan by reason of failing to 
                        have a deductible for selected insulin 
                        products.
                          (ii) Selected insulin products.--For 
                        purposes of this subparagraph--
                                  (I) In general.--The term 
                                ``selected insulin products'' 
                                means any dosage form (such as 
                                vial, pump, or inhaler dosage 
                                forms) of any different type 
                                (such as rapid-acting, short-
                                acting, intermediate-acting, 
                                long-acting, ultra long-acting, 
                                and premixed) of insulin.
                                  (II) Insulin.--The term 
                                ``insulin'' means insulin that 
                                is licensed under subsection 
                                (a) or (k) of section 351 of 
                                the Public Health Service Act 
                                (42 U.S.C. 262) and continues 
                                to be marketed under such 
                                section, including any insulin 
                                product that has been deemed to 
                                be licensed under section 
                                351(a) of such Act pursuant to 
                                section 7002(e)(4) of the 
                                Biologics Price Competition and 
                                Innovation Act of 2009 (Public 
                                Law 111-148) and continues to 
                                be marketed pursuant to such 
                                licensure.
          (3) Permitted insurance.--The term ``permitted 
        insurance'' means--
                  (A) insurance if substantially all of the 
                coverage provided under such insurance relates 
                to--
                          (i) liabilities incurred under 
                        workers' compensation laws,
                          (ii) tort liabilities,
                          (iii) liabilities relating to 
                        ownership or use of property, or
                          (iv) such other similar liabilities 
                        as the Secretary may specify by 
                        regulations,
                  (B) insurance for a specified disease or 
                illness, and
                  (C) insurance paying a fixed amount per day 
                (or other period) of hospitalization.
          (4) Family coverage.--The term ``family coverage'' 
        means any coverage other than self-only coverage.
          (5) Archer MSA.--The term ``Archer MSA'' has the 
        meaning given such term in section 220(d).
  (d) Health savings account.--For purposes of this section--
          (1) In general.--The term ``health savings account'' 
        means a trust created or organized in the United States 
        as a health savings account exclusively for the purpose 
        of paying the qualified medical expenses of the account 
        beneficiary, but only if the written governing 
        instrument creating the trust meets the following 
        requirements:
                  (A) Except in the case of a rollover 
                contribution described in subsection (f)(5) or 
                section 220(f)(5), no contribution will be 
                accepted--
                          (i) unless it is in cash, or
                          (ii) to the extent such contribution, 
                        when added to previous contributions to 
                        the trust for the calendar year, 
                        exceeds the sum of--
                                  (I) the dollar amount in 
                                effect under subsection 
                                (b)(2)(B), and
                                  (II) the dollar amount in 
                                effect under subsection 
                                (b)(3)(B).
                  (B) The trustee is a bank (as defined in 
                section 408(n)), an insurance company (as 
                defined in section 816), or another person who 
                demonstrates to the satisfaction of the 
                Secretary that the manner in which such person 
                will administer the trust will be consistent 
                with the requirements of this section.
                  (C) No part of the trust assets will be 
                invested in life insurance contracts.
                  (D) The assets of the trust will not be 
                commingled with other property except in a 
                common trust fund or common investment fund.
                  (E) The interest of an individual in the 
                balance in his account is nonforfeitable.
          (2) Qualified medical expenses.--
                  (A) In general.--The term ``qualified medical 
                expenses'' means, with respect to an account 
                beneficiary, amounts paid by such beneficiary 
                for medical care (as defined in section 213(d)) 
                for such individual, the spouse of such 
                individual, and any dependent (as defined in 
                section 152, determined without regard to 
                subsections (b)(1), (b)(2), and (d)(1)(B) 
                thereof) of such individual, but only to the 
                extent such amounts are not compensated for by 
                insurance or otherwise. For purposes of this 
                subparagraph, amounts paid for menstrual care 
                products shall be treated as paid for medical 
                care.
                  (B) Health insurance may not be purchased 
                from account.--Subparagraph (A) shall not apply 
                to any payment for insurance.
                  (C) Exceptions.--Subparagraph (B) shall not 
                apply to any expense for coverage under--
                          (i) a health plan during any period 
                        of continuation coverage required under 
                        any Federal law,
                          (ii) a qualified long-term care 
                        insurance contract (as defined in 
                        section 7702B(b)),
                          (iii) a health plan during a period 
                        in which the individual is receiving 
                        unemployment compensation under any 
                        Federal or State law, or
                          (iv) in the case of an account 
                        beneficiary who has attained the age 
                        specified in section 1811 of the Social 
                        Security Act, any health insurance 
                        other than a medicare supplemental 
                        policy (as defined in section 1882 of 
                        the Social Security Act).
                  (D) Menstrual care product.--For purposes of 
                this paragraph, the term ``menstrual care 
                product'' means a tampon, pad, liner, cup, 
                sponge, or similar product used by individuals 
                with respect to menstruation or other genital-
                tract secretions.
          (3) Account beneficiary.--The term ``account 
        beneficiary'' means the individual on whose behalf the 
        health savings account was established.
          (4) Certain rules to apply.--Rules similar to the 
        following rules shall apply for purposes of this 
        section:
                  (A) Section 219(d)(2) (relating to no 
                deduction for rollovers).
                  (B) Section 219(f)(3) (relating to time when 
                contributions deemed made).
                  (C) Except as provided in section 106(d), 
                section 219(f)(5) (relating to employer 
                payments).
                  (D) Section 408(g) (relating to community 
                property laws).
                  (E) Section 408(h) (relating to custodial 
                accounts).
  (e) Tax treatment of accounts.--
          (1) In general.--A health savings account is exempt 
        from taxation under this subtitle unless such account 
        has ceased to be a health savings account. 
        Notwithstanding the preceding sentence, any such 
        account is subject to the taxes imposed by section 511 
        (relating to imposition of tax on unrelated business 
        income of charitable, etc. organizations).
          (2) Account terminations.--Rules similar to the rules 
        of paragraphs (2) and (4) of section 408(e) shall apply 
        to health savings accounts, and any amount treated as 
        distributed under such rules shall be treated as not 
        used to pay qualified medical expenses.
  (f) Tax treatment of distributions.--
          (1) Amounts used for qualified medical expenses.--Any 
        amount paid or distributed out of a health savings 
        account which is used exclusively to pay qualified 
        medical expenses of any account beneficiary shall not 
        be includible in gross income.
          (2) Inclusion of amounts not used for qualified 
        medical expenses.--Any amount paid or distributed out 
        of a health savings account which is not used 
        exclusively to pay the qualified medical expenses of 
        the account beneficiary shall be included in the gross 
        income of such beneficiary.
          (3) Excess contributions returned before due date of 
        return.--
                  (A) In general.--If any excess contribution 
                is contributed for a taxable year to any health 
                savings account of an individual, paragraph (2) 
                shall not apply to distributions from the 
                health savings accounts of such individual (to 
                the extent such distributions do not exceed the 
                aggregate excess contributions to all such 
                accounts of such individual for such year) if--
                          (i) such distribution is received by 
                        the individual on or before the last 
                        day prescribed by law (including 
                        extensions of time) for filing such 
                        individual's return for such taxable 
                        year, and
                          (ii) such distribution is accompanied 
                        by the amount of net income 
                        attributable to such excess 
                        contribution.
                Any net income described in clause (ii) shall 
                be included in the gross income of the 
                individual for the taxable year in which it is 
                received.
                  (B) Excess contribution.--For purposes of 
                subparagraph (A), the term ``excess 
                contribution'' means any contribution (other 
                than a rollover contribution described in 
                paragraph (5) or section 220(f)(5)) which is 
                neither excludable from gross income under 
                section 106(d) nor deductible under this 
                section.
          (4) Additional tax on distributions not used for 
        qualified medical expenses.--
                  (A) In general.--The tax imposed by this 
                chapter on the account beneficiary for any 
                taxable year in which there is a payment or 
                distribution from a health savings account of 
                such beneficiary which is includible in gross 
                income under paragraph (2) shall be increased 
                by 20 percent of the amount which is so 
                includible.
                  (B) Exception for disability or death.--
                Subparagraph (A) shall not apply if the payment 
                or distribution is made after the account 
                beneficiary becomes disabled within the meaning 
                of section 72(m)(7) or dies.
                  (C) Exception for distributions after 
                medicare eligibility.--Subparagraph (A) shall 
                not apply to any payment or distribution after 
                the date on which the account beneficiary 
                attains the age specified in section 1811 of 
                the Social Security Act.
          (5) Rollover contribution.--An amount is described in 
        this paragraph as a rollover contribution if it meets 
        the requirements of subparagraphs (A) and (B).
                  (A) In general.--Paragraph (2) shall not 
                apply to any amount paid or distributed from a 
                health savings account to the account 
                beneficiary to the extent the amount received 
                is paid into a health savings account for the 
                benefit of such beneficiary not later than the 
                60th day after the day on which the beneficiary 
                receives the payment or distribution.
                  (B) Limitation.--This paragraph shall not 
                apply to any amount described in subparagraph 
                (A) received by an individual from a health 
                savings account if, at any time during the 1-
                year period ending on the day of such receipt, 
                such individual received any other amount 
                described in subparagraph (A) from a health 
                savings account which was not includible in the 
                individual's gross income because of the 
                application of this paragraph.
          (6) Coordination with medical expense deduction.--For 
        purposes of determining the amount of the deduction 
        under section 213, any payment or distribution out of a 
        health savings account for qualified medical expenses 
        shall not be treated as an expense paid for medical 
        care.
          (7) Transfer of account incident to divorce.--The 
        transfer of an individual's interest in a health 
        savings account to an individual's spouse or former 
        spouse under a divorce or separation instrument 
        described in clause (i) of section 121(d)(3)(C) shall 
        not be considered a taxable transfer made by such 
        individual notwithstanding any other provision of this 
        subtitle, and such interest shall, after such transfer, 
        be treated as a health savings account with respect to 
        which such spouse is the account beneficiary.
          (8) Treatment after death of account beneficiary.--
                  (A) Treatment if designated beneficiary is 
                spouse.--If the account beneficiary's surviving 
                spouse acquires such beneficiary's interest in 
                a health savings account by reason of being the 
                designated beneficiary of such account at the 
                death of the account beneficiary, such health 
                savings account shall be treated as if the 
                spouse were the account beneficiary.
                  (B) Other cases.--
                          (i) In general.--If, by reason of the 
                        death of the account beneficiary, any 
                        person acquires the account 
                        beneficiary's interest in a health 
                        savings account in a case to which 
                        subparagraph (A) does not apply--
                                  (I) such account shall cease 
                                to be a health savings account 
                                as of the date of death, and
                                  (II) an amount equal to the 
                                fair market value of the assets 
                                in such account on such date 
                                shall be includible if such 
                                person is not the estate of 
                                such beneficiary, in such 
                                person's gross income for the 
                                taxable year which includes 
                                such date, or if such person is 
                                the estate of such beneficiary, 
                                in such beneficiary's gross 
                                income for the last taxable 
                                year of such beneficiary.
                          (ii) Special rules.--
                                  (I) Reduction of inclusion 
                                for predeath expenses.--The 
                                amount includible in gross 
                                income under clause (i) by any 
                                person (other than the estate) 
                                shall be reduced by the amount 
                                of qualified medical expenses 
                                which were incurred by the 
                                decedent before the date of the 
                                decedent's death and paid by 
                                such person within 1 year after 
                                such date.
                                  (II) Deduction for estate 
                                taxes.--An appropriate 
                                deduction shall be allowed 
                                under section 691(c) to any 
                                person (other than the decedent 
                                or the decedent's spouse) with 
                                respect to amounts included in 
                                gross income under clause (i) 
                                by such person.
  (g) Cost-of-living adjustment.--
          (1) In general.--Each dollar amount in subsections 
        (b)(2) and (c)(2)(A) shall be increased by an amount 
        equal to--
                  (A) such dollar amount, multiplied by
                  (B) the cost-of-living adjustment determined 
                under section 1(f)(3) for the calendar year in 
                which such taxable year begins determined by 
                substituting for ``calendar year 2016'' in 
                subparagraph (A)(ii) thereof--
                          (i) except as provided in clause 
                        (ii), ``calendar year 1997'', and
                          (ii) in the case of each dollar 
                        amount in subsection (c)(2)(A), 
                        ``calendar year 2003''.
        In the case of adjustments made for any taxable year 
        beginning after 2007, section 1(f)(4) shall be applied 
        for purposes of this paragraph by substituting ``March 
        31'' for ``August 31'', and the Secretary shall publish 
        the adjusted amounts under subsections (b)(2) and 
        (c)(2)(A) for taxable years beginning in any calendar 
        year no later than June 1 of the preceding calendar 
        year.
          (2) Rounding.--If any increase under paragraph (1) is 
        not a multiple of $50, such increase shall be rounded 
        to the nearest multiple of $50.
  (h) Reports.--The Secretary may require--
          (1) the trustee of a health savings account to make 
        such reports regarding such account to the Secretary 
        and to the account beneficiary with respect to 
        contributions, distributions, the return of excess 
        contributions, and such other matters as the Secretary 
        determines appropriate, and
          (2) any person who provides an individual with a high 
        deductible health plan to make such reports to the 
        Secretary and to the account beneficiary with respect 
        to such plan as the Secretary determines appropriate.
The reports required by this subsection shall be filed at such 
time and in such manner and furnished to such individuals at 
such time and in such manner as may be required by the 
Secretary.

           *       *       *       *       *       *       *


                         VII. DISSENTING VIEWS

                          House of Representatives,
                               Committee on Ways and Means,
                                      Washington, DC, June 7, 2023.

    DISSENTING VIEWS ON TELEHEALTH EXPANSION ACT OF 2023, H.R. 1843

    H.R. 1843 (Steel, R-CA; Schneider, D-IL) makes permanent 
the safe harbor for telehealth services covered under the 
deductible for high deductible health plans (HDHPs), without 
impacting the health services account (HSA) eligibility of such 
a plan. This temporary safe harbor was put in place during the 
COVID-19 pandemic and would be made permanent with this 
legislation. The safe harbor was extended most recently in 
December of 2022 for two years.
    The safe harbor is in effect to study access and usage of 
telehealth. Only five months ago, a bipartisan, bicameral 
agreement was signed into law providing a two-year extension of 
the safe harbor for coverage of telehealth services under the 
HDHP deductible. The two-year extension was intended to provide 
time for Congress to evaluate how this safe harbor is working, 
including potential challenges, and allow for an informed path 
forward. H.R. 1843, which makes permanent the safe harbor, is 
an attempt by Republicans to bypass this bipartisan agreement, 
making a provision permanent that has little empirical data 
about its operation.
    Telehealth has the potential to exacerbate disparities. 
Marginalized communities often face heightened obstacles when 
it comes to utilizing telehealth services due to a myriad of 
issues, including lack of access to appropriate devices or 
broadband. One study showed that numerous groups of patients 
were less likely to utilize telehealth services, including 
Hispanic, Asian, Spanish-speaking, low-income, and Medicaid 
populations.\1\ Permanently allowing HDHPs to cover telehealth 
services under the deductible could benefit wealthier 
individuals who have access to additional resources, while 
lower-income individuals may not benefit from such provisions. 
This approach, inappropriately implemented, could exacerbate 
inequities and allow for more plan benefit designs that are 
discriminatory.
---------------------------------------------------------------------------
    \1\https://onlinelibrary.wiley.com/doi/10.1002/cam4.4518.
---------------------------------------------------------------------------
    This provision is not solely about telehealth access, but 
also about advantaging triple tax-preferred health savings 
accounts (HSAs) that benefit the wealthy. Health plans can 
already provide any allowable pre-deductible services via 
telehealth without any change in law. This legislation would 
vastly expand the scope of services subject to the pre-
deductible safe harbor, only if provided by telehealth. Under 
this policy, if a person with an HDHP wanted an in-person 
physician visit, s/he would be subject to the full cost of care 
until the deductible is met; however, if s/he used a telehealth 
visit, the plan could pay for the visit before the person hit 
his/her deductible (while maintaining an HSA), favoring 
telehealth as a modality of care over any in-person services.
    This policy provides the greatest benefit, as is evidenced 
by the Joint Committee on Taxation analysis, to those in the 
highest income brackets. HSAs are primarily utilized by high-
income earners, those who have the financial wherewithal to set 
aside funds and invest in future medical costs. In fact, 86 
percent of the HSA tax benefits from this policy will go to 
families earning over $100,000 annually.

               DISTRIBUTION OF THE CHANGES IN LIABILITY FROM THE TELEHEALTH EXPANSION ACT OF 2023
----------------------------------------------------------------------------------------------------------------
                                                Tax Year 2025                          Tax Year 2033
                                   -----------------------------------------------------------------------------
                                                  Change in                              Change in
        Income Category (1)          Number of       tax       Total tax    Number of       tax       Total tax
                                      returns     liability      change      returns     liability      change
                                    (thousands)  ($millions)   (percent)   (thousands)  ($millions)   (percent)
----------------------------------------------------------------------------------------------------------------
Less than $10,000.................          (2)          (3)          (4)          (2)          (3)          (4)
$10,000 to $20,000................            2          (3)          (4)          (2)          (3)          (4)
$20,000 to $30,000................            1           -1          0.3            3          (3)          (4)
$30,000 to $40,000................            7           -1          0.3            8           -5          0.7
$40,000 to $50,000................           26           -7          2.4           24           -9          1.2
$50,000 to $75,000................           45          -14          4.8           84          -69          9.4
$75,000 to $100,000...............           35          -18          6.3           74          -84         11.4
$100,000 to $200,000..............           90          -87         29.9          164         -279         38.0
$200,000 to $500,000..............           90         -128         43.9           91         -240         32.6
$500,000 to $1,000,000............           11          -26          9.0           12          -34          4.7
$1,000,000 and over...............            4          -10          3.3            3          -12          1.7
                                   -----------------------------------------------------------------------------
    Total, All Taxpayers..........          311         -293       100.00          464         -735        100.0
----------------------------------------------------------------------------------------------------------------
Source: Joint Committee on Taxation.
Detail may not add to total due to rounding.
(1) The income concept used to place tax returns into income categories is adjusted gross income (``AGI'') plus:
  [1] tax-exempt interest, [2] employer contributions for health plans and life insurance, [3] employer share of
  FICA tax, [4] workers compensation, [5] nontaxable Social Security Benefits, [6] insurance value of Medicare
  benefits, [7] alternative minimum tax preference items, [8] individual share of business taxes, and [9]
  exclude income of U.S. citizens living abroad. Categories are measured at 2023 levels.
(2) Less than 500 returns.
(3) Less than $50,000.
(4) Less than .05 percent.

    Republican legislation aiming to increase the amounts of 
services covered under the deductible of a HDHP is merely an 
attempt to free up additional money for the wealthy to 
contribute to a triple-advantaged savings account, not to 
benefit the most vulnerable.
    The promotion of HDHPs and HSAs will hinder access to care, 
further exacerbating health care inequities. Studies have 
repeatedly demonstrated that high out-of-pocket costs imposed 
by HDHPs result in consumers delaying or neglecting necessary 
care. In fact, according to a Commonwealth Fund study, nearly 
45 percent of adults with high out-of-pocket expenses push off 
or forgo health care services altogether. By attempting to add 
additional services covered under the deductible for HDHPs, 
individuals might be further incentivized to enroll in a plan 
that ultimately provides insufficient coverage and requires 
higher out-of-pocket costs. Furthermore, the promotion of HDHPs 
and HSAs might pose harmful consequences as it relates to 
health care equity. As it stands today, Black and Hispanic 
Americans report facing more obstacles when paying for 
necessary health care services when enrolled in a HDHP than 
White Americans. When stratified by race, there are prominent 
differences in account balances and distributions of HSA 
accounts.
    The legislation contributes to the deficit, while 
predominantly aiding the wealthy. Nearly a week after passing 
the debt ceiling bill, which placed heightened burden on 
vulnerable populations, Republicans seek to add five billion 
dollars to the federal deficit with this bill, 86 percent of 
which will benefit American families that make $100,000 or more 
every year.
                                           Richard E. Neal,
                                                    Ranking Member.

        Ranking Member Richard E. Neal, Opening Statement, 
            Committee on Ways and Means Markup of H.R. 
            1843,
                                           Wednesday, June 7, 2023.
    I thank my colleague Mr. Schneider for his efforts on the 
issue of telehealth, which we can all agree has become an 
important vehicle for accessing care. With that, I'll yield to 
him.

             REPRESENTATIVE SCHNEIDER REMARKS FOR H.R. 1843

    Thank you, Ranking Member Neal, I appreciate it. I believe, 
and I think evidence demonstrates that we saw it during the 
pandemic, telehealth saves time, as representative Steel 
mentioned; it saves money, but most importantly, I believe it 
saves lives.
    Telehealth has been demonstrated to improve outcomes, allow 
people who otherwise wouldn't have access to care to access--
whether it's a primary care physician to talk, perhaps, about a 
child who has an ear infection that might need more attention, 
or someone in the midst of a mental health issue reaching out 
and finding someone they can talk to during a period of 
pandemic where we couldn't meet face to face. I agree with the 
ranking member: we need to understand how to best use it and 
we're learning that. I've often spoken before the pandemic--
folks I knew were from interested to skeptical, ran the 
spectrum. I consider myself now fully evangelical about the 
potential of telehealth both from my personal experience, the 
experience of my family, the experience of my neighbors, 
constituents, and seeing it across the country.
    What's important to me as we move forward is that the 
access to telehealth remain available to everyone needing care. 
At all income levels, in all locations, whether they live in a 
city with congested traffic, or a rural community where the 
nearest physician might be 100 miles away or more. This bill 
would ensure that access to telehealth is not precluded; it is 
protected in keeping these plans in safe harbor. I look forward 
to talking more about this, but I yield back for now. Thank 
you.

                           [all]