Your Health Care Benefit Priorities for Congress

In late June, senior Alliance staff will spend a few days in Washington DC to meet with Illinois and Wisconsin congressional representatives. The purpose of our visit is to build relationships with our elected officials and establish The Alliance and our employer members as a resource on key health care benefit topics.

These are brief visits so we want to use our time well! You can help by letting us know how the following four issues impact you, your employees and your business. Being able to share real stories helps paint a more compelling picture.

Cadillac Tax: The Cadillac Tax is a significant threat to employer-sponsored health care. The recently approved delay of Cadillac Tax implementation is welcome. But lawmakers should understand that most employers have a benefits-planning window of 18 to 24 months. Without a full and permanent repeal of the tax, employers are faced with taking steps now to avoid this tax. This may mean reducing employee benefits or passing increases onto the employees.

Long-term clarity from Congress would help employers plan more effectively. This clarity should include a definitive answer as to whether or not care provided at on site clinics will be counted against the Cadillac Tax.

HSAs and What’s Next: As employers, we encourage use of Health Savings Accounts (HSA) plans for our employees, as doing so comes with tax benefits for the employer and employees. HSAs reward preventive health habits, resulting in fewer sick days, doctors’ visits and hospitalizations. We encourage Congress to expand the HSA program, as outlined in the following proposals:

• HR 5138, Rep. Mike Kelly, Bipartisan HSA Improvement Act of 2018, Allows pre-deductible coverage at onsite and retail clinics for treatment of primary, chronic and preventative care; Increases contribution limits and permits HSA funds to be used for wellness benefits, telehealth services and for over-the-counter medications without a prescription.
• HR 4978, Rep. Diane Black, Chronic Disease Management Act, Amends the Internal Revenue Code, with respect to health savings accounts (HSAs), to allow the high deductible health plans required for an HSA to provide care for chronic conditions with no deductible. The bill covers care and prescription medicines related to the treatment of medically complex chronic conditions which: (1) are substantially disabling or life threatening, (2) have a high risk of hospitalization or other significant adverse health outcomes, and (3) require specialized delivery systems across domains of care.

Wellness Rules: When federal courts vacated the Equal Employment Opportunity Commission (EEOC) rules relating to employer sponsored wellness programs, employers were left in a state of limbo as they wait for further guidance from the EEOC. Well-designed wellness programs have proven to be an effective tool for employees and employers to promote preventive care.  Congress should ask EEOC to submit new proposed rules for review as soon as possible, or should adopt legislation to define acceptable incentives in light of recent court rulings.

Data Liberation: Having data to compare the cost and quality of health care services and providers is a prerequisite for value-based purchasing. We support the Administration’s priorities regarding data liberation and value-based purchasing:

• Promoting transparency among providers, payers, pharmaceutical companies and pharmacies on prices and quality;
• Granting U.S. consumers more access to health information through interoperable and accessible health technology;
• Experimenting with payment models in Medicare and Medicaid that aim to “drive value and quality”; and
• Reducing regulatory burdens that hinder the transition toward value-based payments, such as reporting requirements.

We also support the work led by Sen. Bill Cassidy and his colleagues, who have created the health care transparency initiative.  We support HR 2569, Transparency in All Health Care Pricing Act of 2017, which requires all providers of health care products and services to disclose all prices, including wholesale, retail and discounted, that are accepted by that provider. This bill was introduced last May and has yet to receive a hearing.