What is new in benefits? Well, maybe a lot and maybe not!
As many of you know, under the Trump administration there has been a push to repeal the Affordable Care Act (known as ACA or Obamacare) and replace it with a Republican version. The initial version, the American Health Care Act (AHCA), was passed by the House in May 2017 but did not have the votes to pass the Senate. To combat this, the Senate released The Better Care Reconciliation Act (BCRA), and then a revised version (including the Cruz Amendment) just a couple weeks ago. Unfortunately for the Senate, several Republican senators refused to support the bill and it looks to be on shaky ground. Senator Mitch McConnell is championing the effort but a viable solution is not readily apparent right now. He did try to launch a repeal measure last week but that was derailed with the hospitalization of Senator John McCain and the lack of support from other Republicans.
Some of the features were not all bad, however! Let’s do a quick rundown:
- Both AHCA and BCRA eliminate the employer and individual mandate penalties – technically the penalties are still there but reduced to zero
- Reporting stays in place in its present form (simplified reporting is being explored)
- Both delay the Cadillac tax until 2026
- Both retain but revise subsidies available
- Both retain guaranteed coverage but place some limitations, such as a surcharge for a coverage break longer than 63 days (certificates of coverage may come back into play!)
- Both proposed plans include the ability to reimburse OTC medications/products without prescription from FSA’s
- Both proposed plans repeal the indexed cap of $2600 on FSA maximums
- Both plans align maximum HSA contributions with annual deductible and out-of-pocket maximums
- Both plans allow spouses to make catch-up contributions to HSA’s
- Both plans allow a 60-day lookback for reimbursement from HSA for certain types of expenses
- The revised Senate bill addressed the age 26 issue and how that differs between HSA expense eligibility and other plans
- The revised Senate bill allows HDHP premiums to be paid pre-tax from HSA’s
- The revised Senate bill stipulates that the HDHP is not an eligible plan for HSA’s if it covers abortion
- The revised Senate bill allows catastrophic coverage to be eligible for subsidy, plus expanded eligibility for such coverage to over age 30
- The Cruz Amendment allows carriers to offer coverage that does not meet all statutory requirements as long as they offer one plan that does
Other provisions call for more regulation at the state level versus the federal level. There is also a push to reinvigorate the individual marketplace by modeling it after the DC Marketplace (one of the most successful).
What does this mean you ask? It means absolutely nothing has changed until a bill has actually passed the legislature and signed into law. The healthcare and benefits rollercoaster continues! Stay tuned!