Election Impact on Health Benefit Strategy 

Nov 06 2020

We had planned a post-election webinar for Thursday and went ahead with it even though the outcome of the presidential race was not known. Now it’s Friday morning and we’re still waiting, but whatever the final result is our message to employers is the same: Stay focused on your health benefit strategy. Keep doing the things that are working and pay attention to new opportunities. Most importantly, pursuing ways to better engage your employees and their family members in their health will always be a good idea.

That said, what happens in Washington certainly will affect employer-sponsored health programs. Here’s what we discussed during the webinar:

Biden’s ideas to update the ACA to provide more people with more affordable coverage: removing the 400% of FPL threshold for tax credits, decreasing the affordability threshold, and basing tax credit amounts on the gold plan rather than the silver plan. Thinking back to when the public exchange first opened and the buzz about whether it would lead employers to terminate their plans (it didn’t), we polled the webinar audience of HR professionals to see how they might respond now if those changes made their way through the legislative process and became law. In fact, fewer than 2% said they would consider terminating coverage for all employees and send them to the public exchange. The strongest support was for continuing to offer the current employer plan while helping employees determine if they would be eligible for subsidized coverage on the exchange that would be more affordable than the employer’s medical plan. 

The upcoming ACA case that will go before the Supreme Court. We asked our participants to consider which of the patient protections mandated by the ACA they would continue even if the law were struck down. The top three protections that respondents would keep: no pre-existing condition exclusions (87%), preventive care covered in network with no cost sharing (77%), and child coverage eligibility to age 26 (64%). Fewer employers thought they would continue with no annual dollar limits (33% would maintain no limits), or with the current mandated limit on out-of-pocket maximums (44% would maintain the limit).

Focus areas for your health benefit strategy. As you start thinking about what you want to work on in 2021, here is our list for your consideration: a holistic wellbeing strategy, inclusive benefits to support broader corporate DEI strategy, using digital health tools to support effective and efficient access to care, actively managing pharmacy benefits and exploring innovative ways to engage with healthcare providers.

Your priorities for the next Congress. We gave participants a long list of possible healthcare priorities for the next Congress and let them pick up to five from the list. There were two clear winners: reduce prescription drug prices (83%) and promote greater healthcare cost transparency (66%). Both of those would be a real win for plan sponsors and consumers alike,

We do have one more message for employers: Once we know which party will control the White House, Senate and House of Representatives and what is on their healthcare agendas – make sure your voice is heard! Employers pick up much of the tab for healthcare for around half the American people. That is significant! Mercer is very involved with health policy issues in Washington through our government affairs team. We also support, and participate in, the employer advocacy groups in Washington. We testify on the Hill, meet with lawmakers and staffers, share our survey data, and sometimes are asked to review draft legislation and provide feedback. Please reach out if you/your company would like to be more involved. 

If you missed our Nov. 5 post-election webinar, you can watch the replay here.

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