After the Election, will Employers Get the Health Reform They Want?  

Oct 08 2020

While employers have a lot going on right now (to put it mildly), it’s important to keep thinking ahead. There’s an election coming up and the two candidates have different ideas about what direction to take the US healthcare system. In a recent survey, we asked employers what they would like to see the government prioritize – post-election – in terms of healthcare reform. We provided a list of seven issues affecting employer health programs and asked respondents to rate each one on a scale of 1 (not a priority) to 5 (highest priority).

Given everything, it was a bit surprising that the issue that came out on top was not COVID-related support (such as liability protections, capping vaccination costs, or expanding the tax deduction for childcare expense). In fact, it was only tied for third. Maybe it’s too soon to know what COVID-related support will be needed, or maybe employers don’t see COVID as having much of an impact on their health programs. But employers are very clear about the impact of fast-rising prescription drug costs. Survey respondents believe that reining in drug prices should be the government’s top priority, with actions like speeding generics to market and PBM reforms to address prices and increase competition.


Support for telehealth, which has proven to be so crucial during the pandemic, was ranked second. The government could help by minimizing compliance obstacles and even addressing payment rates (right now, Medicare provides equal reimbursement for virtual and in-person visits rather than payment based on the level of services provided). Improving transparency rounds out the top four. Well over half the respondents would like the government to require more cost and quality information to flow from providers to plans and participants. 

Lower on the priority list are reforms to expand or enhance HSAs; relief from the ACA’s employer shared responsibility requirements; and surprise medical bills. While both campaigns have focused on ending surprise medical bills, they are relatively rare and employers may simply want the government to focus on more pressing issues.

Earlier this week I changed out of my sweats and sat down (virtually) with Tracy Watts, Mercer’s leader for health policy, and Geoff Manville, head of government relations, to talk about employers’ top two priorities -- drug prices and telemedicine – and what action we might expect to see post-election under a Biden or Trump administration. I hope you’ll take a few minutes to listen in.

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