For 2025 and beyond, there are a range of anticipated employee benefit and healthcare related policies proposed for the incoming administration. Generally, the currently known public policy objectives of the new administration focus on multiple healthcare related reforms, as well as policy reforms related to reproductive rights, gender identity, and consumer transparency.
Consumers can anticipate substantial activity related to the Patient Protection and Affordable Care Act (“ACA”), including proposals seeking to extend premium subsidy enhancements available to marketplace insurance subscribers, further promote marketplace competition, and other proposals looking to ease certain consumer protections. Also, watch for expansion of comprehensive coverage alternatives, such as short-term limited duration insurance, Individual Contribution Health Reimbursement Arrangements (“ICHRAs”), Qualified Small Employer Health Reimbursement Arrangements (“QSEHRAs”), Health Savings Accounts (“HSAs”), and the like.
The Centers for Medicare & Medicaid Services (“CMS”) will almost certainly face reforms, including proposals looking to impose federally mandated work requirements upon Medicaid recipients, capping of insulin pricing, expansion of site-neutral payment policies, and reinstated and/or expanded telehealth availabilities and flexibilities (respecting the December 31, 2024, expiration of certain telehealth flexibilities).
Two public policy areas likely to experience significant policy developments are reproductive rights and gender identity. Federal legislative and executive agency rulemaking related to gender identify will likely focus on policies prohibiting or restricting access to gender-affirming care for minors, biological sex-based requirements for team sports participation, regulation of public restroom use, and potentially, repeal of other current federal and state-level nondiscrimination protections. Respecting reproductive rights, look for reduced enforcement of HIPAA privacy protections related to use and disclosure of reproductive rights related information, minimal (if any) federal enforcement of the Emergency Medical Treatment and Labor Act (“EMTLA”), and new agency regulations related to the prescribing and receipt of medication abortion options. Also, there is the potential for repeal or replacement of federal rulemaking related to reproductive rights arising in the context of compliance with final rules published by the Department of Labor implementing the Pregnant Workers Fairness Act (“PWFA”).
Other highlights include strengthened pharmaceutical pricing regulations, expanding the availability and utilization of health savings accounts, rollout of new individual health insurance and expense funding alternatives, and increased transparency in hospital and insurance pricing.
To be sure, the next four years will be undoubtedly marked by significant strides of change respecting the public policies underlying employee benefits, and the American healthcare system, generally.
The following table offers an overview of anticipated policy motivations, as well as the legal and regulatory outcomes associated with each such policy. Respecting each policy initiative, please find the following analytic properties:
- A reform law or policy;
- A subject-matter-based subtopic;
- An overview of the specific underlying policy or proposal;
- Evaluation of the employer impact associated with performance of the policy or proposal, considering:
- The amount of time the proposal might take to distill, design, and implement into an actionable policy or procedure for a private employer; and
- The types, and the volume, of resources required for the employer to effectively administer the policy or proposal respecting its workforce and/or its employee benefit plans;
- Proposed outlook for the passage or implementation of the individual policy proposal.
*Please note that the rating of the employer impact and proposal outlook is based merely upon our opinion of anticipated outcomes.
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