PBGH Provisions for Purchasers included in One Big Beautiful Bill Act

The Purchaser Business Group on Health (“PBGH”), a non-profit coalition representing 40 private employers and public purchasers across the United States, advocated for the inclusion of three key health care policies in the budget reconciliation bill signed into law on July 4 that will improve the health care of those with employer provided insurance. These provisions – which PBGH and many of its members have consistently and extensively supported – provide employers the clarity and pathway they need to continue delivering high-value care to employees.

• Section 71306 makes permanent the ability for purchasers to provide telehealth services pre-deductible to plan members with high-deductible health plans (“HDHPs”). Previously, Congress had operated on a series of temporary safe harbor extensions which expired at the end of 2024.
• Section 71308 makes direct primary care arrangements fully compatible with health savings accounts (“HSAs”). Purchasers will be able to provide direct primary care benefits to their plan members with HSAs, and individuals will be able to use funds from their HSAs to pay for direct primary care arrangements.

• Omission: The bill notably excluded any changes or amendments to the tax exclusion for employer-sponsored insurance (“ESI”). Some lawmakers had expressed tentative interest in considering caps on the ESI tax exclusion as a means of raising revenue to pay for the bill’s tax cut extensions. PBGH advocated to exclude this harmful provision and others from the legislation.

These aspects of the bill demonstrate Congress recognizes the value of enabling employers to provide cost-saving preventive care to employees. The health and wellbeing of America’s workforce will be improved by increased access to valuable telehealth and primary care services.

PBGH and its members are committed to working with Congress and the Administration to remove barriers to care, facilitate direct contracting efforts, increase transparency in the health care system, and increase the health of Americans.