Senators John Thune (R-SD) and Tom Carper (D-DE), introduced the Chronic Disease Management Act of 2019 in the Senate (S. 1948), followed by the introduction of the companion bill in the House of Representatives (H.R. 3709) by Representatives Earl Blumenauer (D-OR) and Tom Reed (R-NY). 

The bipartisan bill states,  “Allowing health savings account-eligible high-deductible health plans to cover chronic disease prevention and treatment on a pre-deductible basis promotes the concept of Value-Based Insurance Design, which is an effective tool to improve the quality and reduce the cost of care for Americans with chronic diseases, with improved outcomes via increased medication adherence, reduced complications, and decreased emergency department visits.”

The bill amends IRS Section 223 (c)(2)(C):

(a) IN GENERAL—Section 223(c)(2) of the Internal Revenue Code of 1986 is amended

by redesignating subparagraph (D) as subparagraph (E) and by inserting after

subparagraph (C) the following new subparagraph:


CHRONIC CONDITIONS—A plan shall not fail to be treated as a high deductible health

plan by reason of failing to have a deductible for care related to the treatment of any

medically complex chronic condition which—

(i) is substantially disabling or life threatening,
(ii) has a high risk of hospitalization or other significant adverse health outcomes, and
(iii) requires specialized delivery systems across domains of care.”

This amendment to the IRS code would provide health savings account eligible high-deductible health plans (HSA-HDHPs) the flexibility to cover services and drugs used to treat chronic diseases before meeting the plan deductible.

What does this mean, and why is it important?

This bill, in conjunction with Executive Order 13877, allows for the development and implementation of High-Deductible Health Plans-Plus (HDHP+).  Adoption of this voluntary, clinically nuanced HDHP+ has the potential to mitigate cost-related non-adherence, enhance patient-centered outcomes, allow for premiums lower than most PPOs and HMOs.  Recent V-BID Center research shows that the HDHP+ would provide millions of Americans a plan option that better meets their clinical and financial needs, and would likely reduce federal expenditures. 

View the resources below for more information on HDHP+.