I 

118TH CONGRESS 

2D SESSION H. R. 7681 

To amend the Internal Revenue Code of 1986 to extend the exemption 

for telehealth services from certain high deductible health plan rules, 

to establish a safe harbor for high deductible health plans with no 

deductible for certain primary care services, and to direct the Comptroller 

General of the United States to conduct a study on the effects of 

such safe harbor. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 13, 2024 

Mr. WENSTRUP (for himself and Mr. SCHNEIDER) introduced the following 

bill; which was referred to the Committee on Ways and Means 

A BILL 

To amend the Internal Revenue Code of 1986 to extend 

the exemption for telehealth services from certain high 

deductible health plan rules, to establish a safe harbor 

for high deductible health plans with no deductible for 

certain primary care services, and to direct the Comptroller General of the United States to conduct a study 

on the effects of such safe harbor. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Primary and Virtual 

3 Care Affordability Act’’. 

4 SEC. 2. EXEMPTION FOR TELEHEALTH SERVICES. 

5 (a) IN GENERAL.—Subparagraph (E) of section 

6 223(c)(2) of the Internal Revenue Code of 1986 is amend7 ed by striking ‘‘January 1, 2025’’ and inserting ‘‘January 

8 1, 2027’’. 

9 (b) EFFECTIVE DATE.—The amendment made by 

10 this section shall take effect on the date of the enactment 

11 of this Act. 

12 SEC. 3. HIGH DEDUCTIBLE HEALTH PLAN SAFE HARBOR 

13 FOR NO DEDUCTIBLE FOR CERTAIN PRIMARY 

14 CARE SERVICES. 

15 (a) IN GENERAL.—Paragraph (2) of section 223(c) 

16 of the Internal Revenue Code of 1986 is amended by add17 ing at the end the following new subparagraph: 

18 ‘‘(G) SAFE HARBOR FOR ABSENCE OF DE19 DUCTIBLE FOR CERTAIN PRIMARY CARE SERV20 ICES.— 

21 ‘‘(i) IN GENERAL.—A plan shall not 

22 fail to be treated as a high deductible 

23 health plan by reason of failing to have a 

24 deductible for primary care services pro25 vided by a qualified provider in any plan 


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1 year beginning on or before December 31, 

2 2023. 

3 ‘‘(ii) PRIMARY CARE SERVICES.—For 

4 purposes of clause (i), the term ‘primary 

5 care services’ means services provided by 

6 primary care practitioners (as defined in 

7 section 1833(x)(2)(A)) of the Social Secu8 rity Act. 

9 ‘‘(iii) QUALIFIED PROVIDER.—For 

10 purposes of clause (i), the term ‘qualified 

11 provider’ means a general practitioner, 

12 family physician, general internist, obste13 trician, gynecologist, pediatrician, geriatric 

14 physician, advanced practice registered 

15 nurse, or physician assistant acting in ac16 cordance with State laws.’’. 

17 (b) EFFECTIVE DATE.—The amendment made by 

18 this section shall apply to plan years beginning after De19 cember 31, 2019. 

20 SEC. 4. STUDY AND REPORTS. 

21 (a) STUDY.—The Comptroller General of the United 

22 States shall complete a study on the effects of the safe 

23 harbor for certain primary care services under section 

24 223(c)(2)(G) of the Internal Revenue Code of 1986 (as 

25 added by section 3). 


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1 (b) REPORTS.— 

2 (1) INTERIM REPORT.—Not later than 365 

3 days after the date of the enactment of this Act, the 

4 Comptroller General of the United States shall pro5 vide a report to Congress containing an analysis of 

6 the results of the study under subsection (a). Such 

7 report shall contain— 

8 (A) an analysis of the effects of the safe 

9 harbor on— 

10 (i) whether plan sponsors opted to in11 corporate changes to their benefit design; 

12 (ii) insurance premiums; 

13 (iii) enrollment in high deductible 

14 health plans; 

15 (iv) utilization of primary care visits, 

16 telehealth visits, emergency department 

17 visits, and hospital admissions; and 

18 (v) the rate of employer implementa19 tion of flexibilities in changes to benefit de20 sign; and 

21 (B) comparisons of patient engagement 

22 with services for those whose employer incor23 porated flexibilities into their benefit design and 

24 those who did not do so. 


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1 (2) FINAL REPORT.—Not later than 365 days 

2 after the interim report under paragraph (1) is 

3 issued, the Comptroller General of the United States 

4 shall provide a final report to Congress containing a 

5 comprehensive analysis of the results of the study 

6 under subsection (a). Such report shall include up7 dated findings, analyses, and comparisons described 

8 in paragraph (1). 

Æ 


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