What H.R. 1 Signals About the Future of Virtual Care: Three Takeaways for Plan Sponsors  

If 2020 was the year of the great paradigm shift for virtual care, 2025 is shaping up to be the summer blockbuster sequel.

H.R. 1, the big 870-page budget reconciliation legislation passed by Congress earlier this month, included an important milestone for virtual care. Recognizing that virtual care can foster better and more affordable healthcare, lawmakers made permanent a policy established at the start of the pandemic allowing first-dollar coverage of telehealth and remote care services for high-deductible health plans.

The policy unlocks new opportunities to drive early intervention, positive health outcomes and more cost-effective care among the 40% of commercially insured Americans who have a high-deductible health plan linked to a health savings account, according to the CDC. This creates the opportunity for better addressing both physical and mental healthcare needs.

In addition to the legislation’s impact on plan sponsors in the near term, it’s also a powerful signal that virtual care is now a foundational aspect of our healthcare delivery ecosystem. Here are three important takeaways for plan sponsors:

1. First-dollar insurance coverage lowers barriers to care, fueling preventive care and downstream healthcare cost savings.

   Virtual care is proven as a powerful tool for preventive care—it’s a key reason that Congress made permanent first-dollar coverage across the breadth of virtual care services. It unlocks cost choice at the member level in ways that lower the cost of care and support a healthy, productive workforce.

   Studies show that waiving deductibles for virtual care under high-deductible health plans can help ensure patients access the care they need.

   Our data validates this insight. Across our expansive range of clinical services, we have seen that the copay structure has a significant impact on outcomes and engagement. In fact, in our primary care service, Primary360, utilization is typically two to three times higher when clients set copays at $0.ⁱ As a result, people are getting recommended screenings, early identification and care for chronic diseases like diabetes, and reducing the risk of more costly downstream health issues. Additionally, data show it can be a high-quality, more convenient and lower-cost alternative to the use of in-person ER and urgent care facilities.ⁱⁱ

2. Virtual care can address a range of conditions and populations.

   As benefit sponsors evaluate various virtual care programs, many are looking to prioritize solutions that offer high-quality integrated care—not just for adults but also for adolescents and children, those living in rural communities and populations with limited English proficiency, many of whom have different access needs. As policymakers make significant changes to how healthcare is funded in the U.S., affordability and flexible access will become top of mind for many Americans as they navigate this transition in their local communities.

   Now, more than ever, plan sponsors should prioritize virtual care solutions that are equipped to deliver a seamless experience for members. Teladoc Health has made new enhancements this year to connect and assist virtual and in-person care teams to better coordinate care, which drives positive health outcomes. These capabilities help unlock more value for both patients and plan sponsors, using data insights to support clinicians in closing care gaps and improving population health.

3. The time is now to explore plan designs maximizing use of virtual care and to turn to partners with proven success.

   Benefits leaders were already incorporating virtual care into their multi-year strategies, and we see indicators that this will accelerate in 2026.

   Because of these new, important changes to the law, plan sponsors now have the flexibility to design cost-effective, modern benefits packages that leverage virtual care, optimized for access and early intervention. For many, this will include expanding their investment in virtual primary care.

   Virtual health plans, such as the Luminare Health myVirtualCare Access plan, have been accelerating in the last several years, as plan sponsors and members realize the growing body of evidence that these tools can support prevention and early diagnosis of conditions in powerful ways.   

   In our primary care program, we are caring for members who have not otherwise engaged in care. As a result, 49% of diabetes diagnoses and 41% of hypertension diagnoses in our Primary360 program are diagnosed for the first time.ⁱⁱⁱ Catching chronic conditions earlier enables patients to engage with providers and specialists to prevent disease progression and even reduce visits to the emergency department. A recent analysis of a large health plan that offers Primary360 found that people engaged with virtual primary care had 19% fewer emergency department visits. 

   Our clients choose to partner with us because of these meaningful results, which we can deliver because we have the infrastructure, data and clinical resources to create results at scale.

Finally, because the temporary provisions allowing first-dollar coverage of virtual care for high-deductible health plans are now permanent, plan sponsors can now confidently invest in these innovative models for the long term.

Looking forward, employers and plans have more flexibility than ever to empower better outcomes and equip people with access to high-quality virtual care to effectively and affordably take control of their health.

As previously seen on Forbes.com