Congress is unlikely to deal with health care and retirement issues this year



It’s no secret that this Congress hasn’t been the most productive, said Geoff Manville, a partner at Mercers Law and Policy Group, in a recent webinar. However, some bipartisan health care reforms could reach Congress by the end of 2024, he said.

Among the health care reforms that could come up for a vote in the year-end lame duck session are:

  • Reforms of the pharmacy benefits manager. These include broad disclosure of PBM business practices to plan sponsors and the government; a ban on differential pricing and a 100% pass-through of rebates, fees and discounts to the plan sponsor. The proposed reforms would also require PBMs and third-party administrators to disclose direct and indirect compensation to plan fiduciaries.
  • Price transparency. This would codify rules requiring disclosure of out-of-pocket costs and negotiated rates to plan members and beneficiaries.
  • Provider and hospital invoicing reforms. It would require hospital outpatient departments to provide a unique identifier on all bills and would prohibit contract terms that prevent patients from being directed to higher-value, lower-cost providers.
  • Telehealth flexibilities. This would treat stand-alone telehealth and telecare benefits as an excepted benefit.
  • Modernization of the health savings account. This would allow people to convert their own Flexible Spending Arrangements or Health Reimbursement Agreement funds into an HSA.

No action on retirement policy is expected in Congress

Manville said Congress is unlikely to take action on retirement policy this year. However, two issues could be actionable in this session, he added.

The House of Representatives passed HR 2799, a package of changes to the securities law. Included in this package is a provision to allow 403(b) plans to invest in group trusts. Manville said the bill is now in the Senate, where its future is uncertain.

Lawmakers continue to work on a SECURE 2.0 technical fixes bill. A bill has been compiled and may become part of a legislative vehicle to come up for a vote in the lame duck session, Manville said.

There is little chance that any ESG-related legislation will pass before the new Congress takes office next year, he said. Two environmental, social and investment governance bills have stalled in Congress and are unlikely to see further action.

However, Manville said, some recent legislation could set the stage for a potential reform package to be introduced before the next Congress. This legislation includes:

  • HR 7293, which would require many employers to prospectively offer an automatic contribution retirement plan or an automatic individual retirement account.
  • HR 6757, which would allow the transfer of the Roth IRA plan account to Roth.
  • S 3305, the Helping Young Americans Save for Retirement Act, which would lower the plan’s eligibility age to 18.
  • HR 4924 and S 2517, the Automatic Reenrollment Act, which would encourage the adoption of automatic reenrollment in retirement plans.

Also, Manville said, there is interest in the Senate in proposals that would strengthen defined benefit pension plans.

Health care in the presidential campaign

Health care affordability is a key focus for President Joe Biden and his Republican rival Donald Trump as the two face off in a rematch for the presidency in 2024.

Biden outlined his health care priorities in his 2025 budget request to Congress. These priorities include:

  • Extending the Inflation Reduction Act’s prescription drug cost controls and limits to employer plans.
  • Address the consolidation of the sector and anti-competitive practices.
  • Require insurers to cover three mental health care visits without cost sharing each year.
  • Establish a national paid leave program managed by the Social Security Administration.

In the meantime, Manville said, Trump wants to revisit his previous health care priorities, which include:

  • Reduction of premiums and costs of medicines.
  • Increased price transparency.
  • Expand coverage options that do not meet the requirements of the Affordable Care Act, such as association health plans, short-term limited-duration plans, and defined benefit plans.

Susan Rupe is editor-in-chief of InsuranceNewsNet. She previously served as communications director for an insurance agent association and was an award-winning journalist and editor. Contact her at [email protected]. Follow her on X @INNsusan.

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