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November 18, 2021

Dear Congresswoman Steel and Congresswoman Lee,

Thank you for your bipartisan leadership to protect affordable access to telehealth benefits for those who are enrolled in a high-deductible health plan paired with a health savings account (HSA).  The Alliance to Fight for Health Care is a broad-based coalition comprised of businesses, patient advocates, employer organizations, unions, health care companies, consumer groups, and other stakeholders that support employer-provided health coverage.

Employer Focus on Addressing Mental Health Needs During the Pandemic

The Coronavirus Aid Relief and Economic Security (CARES) Act provided employers with the temporary ability to provide telehealth without applying a deductible to employees with a health savings account.  This flexibility expires on December 31, 2021. We strongly support your legislation, HR 5981, which would permanently extend this flexibility and urge Congress to pass HR 5981 before this temporary flexibility expires.

During the pandemic, about 4 in 10 adults in the U.S. reported symptoms of anxiety or depressive disorder, up from one in ten adults who reported these symptoms from January to June 2019.[1] In the face of this challenge, employers pivoted to provide new and expanded mental and behavioral health resources for their employees. Despite economic uncertainty, 68% of large employers added or expanded benefits or resources to meet employee needs in response to the pandemic.[2]

Already an area of acute focus, employers doubled down on mental health and emotional well-being to meet employee needs. In an informal survey of large employers, 85% said supporting and/or expanding access to mental health care for employees was a top priority for their organization.[3] In another survey conducted a year into the pandemic, 50% of employers reported that employees were taking greater advantage of company mental health resources.[4] This includes expanded access to virtual care and on-demand telemental health; enriched EAP benefits to help employees manage their wellness; newly eliminated copayments for mental health encounters; and added voluntary and supplemental benefits aimed at addressing overall wellbeing (e.g. financial wellness, caregiving supports, enhanced leave, sleep management, and more).

According to the Business Group on Health’s (BGH) 2022 “Large Employers’ Health Care Strategy and Plan Design Survey,” a true silver lining of the pandemic has been the significant investments made in virtual and mental health offerings, many of which will become permanent. These include expanded telehealth or virtual health offerings (76%), better access to virtual health (68%) and new mental health benefits (62%). When it comes to mental health treatment, employers are also enhancing access through reduced out-of-pocket costs for employees. For 2022, 75% of large employers are offering access to lower- or no-cost mental health support through their telemental health provider and 33% are offering lower cost counseling services at the worksite – bringing services directly to employees wherever they are.[5] Without your legislation, employers will be required to charge employees more to access this care; throwing up another barrier to treatment.

In a recent Morning Consult National Tracking Poll sponsored by the Alliance, seven in ten insured adults (71%) feel it is important that they are able to access telehealth services under their current health care plan and 89% rated their or their family member’s previous telehealth visit(s) as good or excellent. A fifth of insured American adults have personally had a telehealth appointment for their mental health care and nearly two-thirds are willing to receive mental health care virtually through a telehealth system.[6]

The support for affordable telehealth and telemental health is strong. We look forward to working with you and laud you and your bipartisan cosponsors for your work to ensure that this important flexibility does not expire.


The Alliance to Fight for Health Care

[1] Kaiser Family Foundation, “The Implications of COVID-19 for Mental Health and Substance Use,” February 10, 2021.

[2] 2020 Mercer National Survey of Employer-Sponsored Health Plans

[3] Informal survey of American Benefits Council companies, October 27, 2021.

[4] Arizona State University College of Health Solutions, “Back to the Workplace: Are we there yet? Key Insights from Employers One Year Into the Pandemic,” April 2021.

[5] Business Group on Health, “2022 Large Employers’ Health Care Strategy and Plan Design Survey,” August 2021.

[6] Morning Consult National Tracking Poll, November 1-8, 2021.


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