S. 1948Senate116th Congress (2019-2021)In Committee

Chronic Disease Management Act of 2019

Sponsored by John ThuneSen. John Thune (R-SD)
Introduced June 24, 2019

AI-Generated Summary

Updated April 14, 2026 at 6:35 AM UTC

The Chronic Disease Management Act of 2019 changes the tax rules for high‑deductible health plans (HDHPs). It lets these plans cover preventive and treatment services for certain chronic illnesses before a member has met the plan’s deductible. The change is aimed at improving care for people with chronic conditions and reducing overall health costs.

Key Provisions

  • Amends the Internal Revenue Code (Section 223(c)(2)) to add a new safe‑harbor rule: an HDHP will still qualify as a high‑deductible plan even if it provides care for chronic conditions without first applying the deductible.
  • Specifies that the Assistant Secretary for Health will determine which conditions qualify for the pre‑deductible coverage.
  • Redesignates the existing subparagraph (D) as (E) and inserts the new subparagraph (D) to create the safe‑harbor provision.
  • The amendment takes effect for coverage periods that begin after the law is enacted.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text: CR S4458-4459)

June 24, 2019

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SenateIntro Referral

Introduced in Senate

June 24, 2019

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text: CR S4458-4459)

June 24, 2019

Floor Debate

2 members

What members said about S. 1948 on the floor

2 Republicans
Susan M. Collins
Sen. Susan M. CollinsR-ME · Jun 24, 2019

Mr. President, I am pleased to join my colleague from Minnesota, Senator Smith, in introducing the School Food Modernization Act to assist schools in updating outdated kitchen equipment, allowing…

John Thune
Sen. John ThuneR-SD · Jun 24, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

John Thune
Sen. John ThuneR-SD · Jun 24, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

Latest available legislative text

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Introduced in SenateIssued June 24, 2019

II

116th CONGRESS

1st Session

S. 1948

IN THE SENATE OF THE UNITED STATES

June 24, 2019

Mr. Thune (for himself and Mr. Carper) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend the Internal Revenue Code of 1986 to permit high-deductible health plans to provide chronic disease prevention services to plan enrollees prior to satisfying their plan deductible.

1.

Short title; findings

(a)

Short title

This Act may be cited as the Chronic Disease Management Act of 2019.

(b)

Findings

Congress finds the following:

(1)

A small number of chronic diseases account for the majority of health care spending in the United States.

(2)

The Office of the Assistant Secretary for Health of the Department of Health and Human Services used a deliberative process involving the Multiple Chronic Conditions working group subject matter experts in clinical medicine, epidemiology, and public health to develop a list of 20 chronic conditions that are prevalent and potentially amenable to public health or clinical interventions, or a combination of both.

(3)

Limited and targeted interventions for many chronic diseases prevent the need for additional, more costly therapies associated with untreated or unmanaged chronic diseases that lead to adverse effects on quality of life for patients.

(4)

These types of chronic care preventive services should be encouraged to maximize the effectiveness and positive outcomes of the care provided under high-deductible health plans.

(5)

Section 223(c)(2)(C) of the Internal Revenue Code of 1986 explicitly grants the Secretary of the Treasury flexibility in defining the scope of preventive care for purposes of the preventive care safe harbor. As of the date of introduction of this Act, the Secretary of the Treasury has refrained from exercising existing authority under such section to expand the preventive care safe harbor to include chronic disease prevention.

(6)

In the absence of an expansion of the preventive care safe harbor by the Secretary of the Treasury, the Chronic Disease Management Act of 2019 would expressly permit high-deductible health plans to provide chronic disease prevention and treatment, subject to certain limitations, prior to a plan enrollee having met their plan deductible.

(7)

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.

2.

Chronic disease prevention

(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:

(D)

Safe harbor for absence of deductible for care related to 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 chronic condition, as determined by the Assistant Secretary for Health of the Department of Health and Human Services.

.

(b)

Effective date

The amendments made by this section shall apply to coverage for months beginning after the date of the enactment of this Act.