While advisers are growing increasingly wary of what new healthcare legislation could mean for employer-sponsored benefits, some of their concerns may be premature, experts say.
There has been significant noise in Washington surrounding legislation like Medicare for All — a type of single payer coverage — and the No Surprises Act — which would address balance billing. But the impact on the insurance industry isn’t yet clear.
“I think we have many threats, but Medicare for All is not really one of them right now,” said Ethan Kahn, partner at the not-for-profit practice group at consulting firm Mazars USA, speaking this week at Spark HR, an HR and finance forum in New York.
Backed by several presidential front-runners, including Elizabeth Warren, Bernie Sanders and Kamala Harris, some experts say the Medicare for All program could have a big impact on organizations’ healthcare benefits. A
Regardless, it may be too soon to tell what the impact will be for employers. It is unlikely the legislation will pass in the Senate with a Republican majority, Kahn added.
“I do have a lot of long-term worries about erosion of the employer providing group health insurance,” Kahn said. “[But], as a general matter, I don’t think we’re gonna see a cataclysmic event.”
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Meanwhile, legislation on surprise billing is getting bipartisan support — and employers should be paying attention. In mid-May, Sen. Bill Cassidy, R-La., and Sen. Maggie Hassan, D-N.H., introduced their version of a surprise medical bill legislation, the STOP Surprise Medical Bills Act, which would prohibit balance billing in certain scenarios such as receiving emergency care at an out of network hospital.
“The patient can wind up with a bill for out-of-network care. [It is a] big problem that both Democrats and Republicans have tried to tackle,” said Dan Kuperstein, senior vice president of compliance at benefits firm Corporate Synergies.
Some states have been pushing for laws that would help address balance billing, said Joel Wood, senior vice president of government affairs at the Council of Insurance Agents & Brokers. Although a few have already adopted surprise billing laws or balanced billing laws, employers, insurers, doctors and hospitals cannot agree on the best way to tackle this issue, he said.
“Insurers and employers want to see some sort of standard for what a median in-network charge would be, whereas the providers, hospitals and the doctors, want to see arbitration similar to New York standard,” he added.
Another one of President Trump’s healthcare initiatives is association health plans, or AHPs, which allow businesses and individuals to band together to create group health plans that offer less expensive coverage than the affordable care act — but without some of its protections.
But in March, U.S. District Judge John Bates in Washington blocked the administration’s plans, ruling the policy violated the Affordable Care Act.
“It’s a problem that it’s the classic state rights vs. federal rights. The fact is that the states want to regulate insurance, because they want to protect the residents of their state,” said Alan Hahn, partner of benefits and compensation at the law firm David & Gilbert. “That comes at a cost where you have 50 insurance commissioners, and they’re all going to have their own set of rules, and they’re all going to have their own mandates.”
Enforcing an association health plan can be particularly troublesome for organizations and companies that have a national presence with employees or offices in several states, CIAB’s Wood said.
“The national restaurant association would be the classic example of an association health plan that you would think would work,” he said. “About six months ago they rolled out their association health plan, it had 272 different plans within it, because you could not override individual state laws.”
