The One Big Beautiful Bill Act has drawn criticism from healthcare groups for slashing Medicaid and ACA subsidies, but it contains a few provisions that could drive progress.<\/p>\n\n\n\n
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When President Donald Trump signed the One Big Beautiful Bill Act into law earlier this month, the reaction from healthcare groups was overwhelmingly negative<\/a> (Opens in a new window).<\/p>\n\n\n\n The law slashed Medicaid spending by hundreds of billions of dollars over the next decade and eliminated Affordable Care Act subsidies. Experts say<\/a> (Opens in a new window)the passage of this legislation will cause uncompensated care costs to balloon, leading to hospital closures and diminished care access, particularly among rural hospitals and underserved populations.<\/p>\n\n\n\n However, amid the gloom, there are a small handful of notable provisions that could contribute to meaningful progress in the healthcare sector.<\/p>\n\n\n\n Some promising healthcare policies tucked inside the bill include expanded telehealth access, new tax incentives for domestic medical manufacturing, support for pharmaceutical research, and a growing opportunity for employers to innovate in health benefits design.<\/p>\n\n\n\n There was a major telehealth win in the law. It permanently extends first-dollar telehealth coverage for high deductible health plans \u2014 meaning people with these plans can have peace of mind that their telehealth visits will be covered before they meet their deductibles, and they get to keep their health savings account benefits.<\/p>\n\n\n\n The American Telemedicine Association<\/a> (Opens in a new window), which has been advocating for the permanent extension of telehealth coverage for the past five years, said the change is a major milestone for telehealth. <\/p>\n\n\n\n \u201cMaking this permanent will provide certainty for healthcare providers, and employers, improve health outcomes, strengthen employer-sponsored health benefits, and reduce disparities in care,\u201d Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, said in a statement.<\/p>\n\n\n\n About half of the private workforce is enrolled in high deductible health plans, noted Caroline Savello, president of Color Health<\/a> (Opens in a new window), a telehealth company that provides screenings and counseling for cancer.<\/p>\n\n\n\n High deductible health plan enrollees often end up avoiding care due to cost, so this change removes a key barrier by covering telehealth services up front, she explained.<\/p>\n\n\n\n \u201cHigh deductible health plan limits are often higher than the household savings patients have on hand. And we know that care seeking among those on these medical plans is overall worse. This [coverage extension] is making it very, very feasible to access a tremendous array of preventive health services in particular, as well as ongoing care for folks on these plans on a permanent basis \u2014 and through a really cost-effective model, which I think telehealth has proven to be,\u201d Savello remarked.<\/p>\n\n\n\n Over the past few years, employers have been hesitant to fully adopt or promote telehealth offerings because of regulatory uncertainty. Now, Savello believes they can confidently expand access to these services.<\/p>\n\n\n\n Boosting telehealth access will help lower overall healthcare costs, she noted, by shifting care away from high cost settings and making it more realistic for people to get timely treatment before their conditions become more serious and expensive. Greater access also will lead to better care quality across the nation\u2019s rural communities, Savello added.<\/p>\n\n\n\n Telehealth dramatically improves access to specialists in rural areas, where healthcare infrastructure has rapidly declined<\/a> (Opens in a new window)in recent years, she said. In many of these regions, hospitals have closed and specialist providers are scarce \u2014 leaving patients with the choice of traveling hours or going without care.<\/p>\n\n\n\n Virtual services can bridge that gap by connecting patients to expert care from their home or local clinic.<\/p>\n\n\n\n \u201cWe\u2019ve seen cancer hospitals close in rural areas, and we definitely see huge limits on cancer specialist access. So that shift to virtual access to specialists is very important to us and to the employers that we work with,\u201d Savello stated.<\/p>\n\n\n\n By ensuring permanent coverage for telehealth, the extension brings much-awaited stability to virtual care.<\/p>\n\n\n\n The One Big Beautiful Bill Act\u2019s failure to extend Affordable Care Act tax credits<\/a> (Opens in a new window)or protect Medicaid coverage<\/a> (Opens in a new window)creates an opportunity for employers to step up with innovative health benefits designs, especially in a tight labor market, pointed out Ben Light, vice president of partnerships at Zorro<\/a> (Opens in a new window). <\/p>\n\n\n\n His company is a benefits platform that helps employers offer health coverage through individual coverage health reimbursement arrangements (ICHRAs). Under these arrangements, employers provide workers a fixed amount of pre-tax money to buy their own individual health coverage and pay for health expenses.<\/p>\n\n\n\n \u201cWe\u2019re in a highly competitive labor market, and now you have employees who are going to lose their coverage through Medicaid or through the ACA and its expanded tax credits. They\u2019re going to look somewhere to find support \u2014 and I think they\u2019re going to look to their employers. If you\u2019re an employer who can find a way to be generous with contributions to people\u2019s insurance, then I think you\u2019re going to do quite well,\u201d Light declared.<\/p>\n\n\n\n Employers can launch an ICHRA solution in just a few weeks, and doing so would provide much needed support for employees who lose coverage, he said. He noted that ICHRAs can help lower employers\u2019 overall costs as well by pooling workers into the individual market.<\/p>\n\n\n\n Those savings, Light explained, can then be reinvested in other benefits, such as direct primary care subscriptions. He highlighted new provisions in the law that allow health savings accounts to be used for direct primary care \u2014 a model he thinks is underappreciated but valuable, as they offer longer visits and better access to physicians compared to traditional models. <\/p>\n\n\n\n \u201cSomeone can now have a 45-minute appointment or can have more access to their physician, instead of being shuffled in and out in 10 minutes and maybe not get the treatment that they want,\u201d Light stated.<\/p>\n\n\n\n This could represent a meaningful shift toward more personalized, proactive care, he added.<\/p>\n\n\n\n He said it will be interesting to watch how employers might play a bigger role in keeping Americans healthy and insured as public programs fall short.<\/p>\n\n\n\n The recently passed law is a \u201cgrand slam\u201d for domestic medical manufacturers, according to Eric Axel, executive director of the American Medical Manufacturers Association<\/a> (Opens in a new window). <\/p>\n\n\n\n The legislation includes new funding and policy direction for the strategic national stockpile, a domestic reserve of personal protective equipment and other critical medical supplies. It also features new tax incentives for capital investment, research and development, and domestic production, which Axel believes will help level the playing field with heavily subsidized foreign competitors. <\/p>\n\n\n\n These competitors, of which China is the most notable, receive extensive government support, infrastructure and tax advantages \u2014 perks that stateside manufacturers have historically gone without, he said.<\/p>\n\n\n\n With the passage of this law, U.S. manufacturers can immediately write off the cost of new machinery and facilities, as well as deduct research and development expenses in the same tax year instead of spreading them over 15 years, Axel explained.<\/p>\n\n\n\n The law also eliminates the federal tax on overtime pay, which will help companies ramp up manufacturing during surges in demand.<\/p>\n\n\n\n \u201cIf you offer overtime, a lot of times, workers wouldn\u2019t take it. They would say, \u2018Oh, I\u2019m going to just pay it in taxes, or it\u2019s going to dump me into another tax bracket.\u2019 So no taxes on overtime for hourly workers in these sectors \u2014 it\u2019s a big deal. They will be willing to take more shifts, they can earn more money, and they can keep the money in their pocket,\u201d Axel remarked.<\/p>\n\n\n\n From his perspective, the One Big Beautiful Bill Act signals a long-overdue federal commitment to rebuilding the nation\u2019s medical manufacturing base.<\/p>\n\n\n\nBoosting telehealth access<\/strong><\/h6>\n\n\n\n
Giving employers an opportunity to shine<\/strong><\/h6>\n\n\n\n
Onshoring the nation\u2019s medical manufacturing <\/strong><\/h6>\n\n\n\n
Pharma sees some wins<\/strong><\/h6>\n\n\n\n