Why HR 1 Is a Game-Changer for Telehealth – and What It Means for Employers and Health Plans

On July 4, 2025, HR 1 was signed into law – introducing sweeping, long-term reforms across several areas of healthcare delivery. For those of us managing benefits, digital health strategies, or plan design, one particular change deserves attention: first-dollar coverage for telehealth in High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs).

What Changed with HR 1

Before HR 1, HDHPs could only cover telehealth before the deductible was met through temporary waivers – mainly driven by pandemic-era flexibility (see IRS Notice 2020-15). This created an annual policy guessing game for employers and left gaps in coverage.

HR 1 ends that uncertainty. Section 71306 of the bill permanently allows HDHPs to offer telehealth coverage without requiring members to meet their deductible first, what’s commonly referred to as “first-dollar coverage.” Importantly, this change is retroactive to December 31, 2024.

Why It Matters to Employers and Health Plans

1. Encourages Early Engagement
   Telehealth is no longer cost-prohibitive for employees with HDHPs, enabling earlier, more frequent access to care. This prevents delayed diagnoses and can reduce downstream costs by avoiding ER visits and unmanaged chronic conditions (Milliman).

2. Controls Total Cost of Care
   Virtual visits typically cost $90–$120 less than in-person alternatives. Widespread adoption of telehealth, particularly for non-emergent care, can reduce overall claims spend while improving employee satisfaction (KFF).

3. Reduces Confusion Around HSA Eligibility
   Employers and plans can now promote telehealth without risking members’ HSA eligibility. The rules are clear, permanent, and align with broader consumer expectations around digital-first experiences (EBRI).

4. Adds Predictability for Benefit Planning
   With permanent federal policy in place, benefits leaders can confidently incorporate telehealth into multi-year strategies – no more waiting on short-term renewals from Congress or legal gray areas.

A Security and Infrastructure Perspective

From a digital infrastructure lens, this shift reinforces the need for secure, scalable virtual care platforms. As more members engage in digital health experiences, employers and health plans must prioritize data privacy, interoperability, and regulatory compliance. At Solera, we’ve designed our virtual specialty care network with these imperatives in mind, protecting member data while optimizing ease of access and experience. 

The Bigger Picture

This move cements telehealth as a foundational component of modern healthcare delivery. Alongside expanded Medicare telehealth coverage and support for direct primary care in HR 1, it reflects a strong bipartisan shift toward accessible, lower-cost care models.

For employers and plans, this isn’t just about coverage – it’s about rethinking how we enable and encourage smarter care choices across populations.

Key Takeaways

• HR 1 permanently allows first-dollar coverage for telehealth under HDHP-HSA plans.

• This improves access, reduces total cost of care, and supports earlier engagement.

• Retroactive to December 31, 2024, closing gaps in coverage.

• Removes regulatory uncertainty, enabling long-term planning.

• Requires secure infrastructure to support increased digital utilization.

‍