The outcome of the current presidential race, along with control of both houses of Congress, will have a significant impact on many healthcare and employee benefits issues, at least for the next four years. These issues include the Affordable Care Act (ACA), Medicare, Medicaid, prescription drug pricing, and transparency in healthcare costs, among other issues.
No matter which political party controls the White House or each chamber of Congress, one major issue is the upcoming expiration of the Tax Cuts & Jobs Act (“the Act”) on December 31, 2025. If provisions in the Act expire, most people will feel the impact in one way or another, as these provisions relate to tax brackets, income tax rates, the child tax credit, state and local tax deductions, mortgage interest deductions, and more. For the purposes of plan sponsors and employers, the expiration of the Act could result in the removal of or changes to the employer-sponsored health insurance premium tax exclusion, which could drastically affect the healthcare system.
Another major issue is prescription drug costs, particularly when it comes to transparency. Employers complain that they are receiving little or no information about pharmacy benefit managers (PBMs), including how they are paid, how formularies are created, and what pharmacies they prefer. The Consolidated Appropriations Act in 2021 prohibited group health plan fiduciaries from contracting with service providers unless they disclosed the revenue they would receive. Nonetheless, the largest PBMs have refused to comply with these disclosure requirements, necessitating additional legislation that remains pending in both the Senate and House.
Healthcare options are one policy area in which presidential candidates have made their opinions clear. Kamala Harris supports maintaining and expanding the ACA, with a focus on government involvement to ensure affordable health care for all. In contrast, Donald Trump emphasizes the replacement of the ACA with a currently undefined concept based on the free market and a lack of government involvement. He also advocates for the increased use of Health Reimbursement Arrangements, including the Individual Coverage HRA (ICHRA).
Furthermore, not only national races impact healthcare policy. State and local elections also can significantly affect benefit advisors and employers. As a result, advisors must track policy positions and potential changes nationally, but also in their local jurisdictions.
Regardless of the outcome, however, benefits advisors must be poised to offer nontraditional solutions to self-funded plans and traditional fully insured plans. Healthcare costs will continue to rise, and offering multiple plan options is the best way to combat costs and meet employees’ needs.
HBL has experience in all areas of benefits and employment law, offering a comprehensive solution to all your business benefits and H.R./employment needs. We help ensure you are in compliance with the complex requirements of ERISA and the IRS code, as well as those laws that impact you and your employees. Together, we reduce your exposure to potential legal or financial penalties. Learn more by calling 470-571-1007.
Hall Benefits Law, LLC
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