Major Health Care Overhaul Dead For Now, Mercer Says

President-elect Joe Biden’s health care agenda “seems likely out the window” unless Democrats gain control of the Senate.

That was one of the highlights of a Mercer webinar on the impact of last week’s election on health and retirement benefits.

Geoff Manville, partner with Mercer’s Law and Policy Group, said with Republican control of the Senate appearing likely, the Democrats’ hopes for health care, family leave, retirement and tax reforms are scuttled.

The top priority for a Biden administration, he said, is to enact COVID-19 aid legislation if Congress doesn’t do so in the lame duck session.

Among the key post-election takeaways, Manville said, are:

• Major health care, retirement and paid leave coverage expansions, as well as big tax changes are dead for now.
• With narrow majorities in both houses of Congress, bipartisanship will be required in order to accomplish much of anything. States will continue to fill the policy vacuum that Congress might be unable to do.
• Biden will use executive and regulatory authority to pursue more incremental policy goals.
• The Biden administration is likely to take steps to revise or undo some Trump health and retirement rules.
• Republicans in the Senate will have a major role in shaping the Biden cabinet.

Congressional Republicans favor a smaller COVID-19 relief package than Democrats are after, Manville said. Some proposed COVID-19 aid provisions that could affect health and retirement benefits include:

• No cost-sharing coverage of COVID-19 treatment.
• Flexibility and enhancements for flexible spending arrangements and cafeteria plans.
• Enhanced employee retention tax credits.
• Continued support for telehealth.
• Credit equal to 50% of employer costs for back-to-work expenses, including COVID-19 testing.
• Broad COVID-19-related liability protection for employers.
• Expanded emergency paid leave requirements.
• Pension funding relief for single-employer plans.
• Multiemployer pension reforms.
• Separate action possible on SECURE 2.0 legislation.

Both parties in Congress could find common ground on several issues, Manville said. Although Democrats’ plans for major Affordable Care Act expansion, a public option and lowering the Medicare eligibility age are off the table, a number of issues could get attention regardless of which party controls Congress. Those issues include:

• Drug pricing.
• Eliminating surprise medical bills.
• Expanding telehealth.
• Paid leave.
• Medicare solvency.
• Value-based health savings account reforms.

As for retirement issues, Manville said, Democrats’ plans for “equalizing” tax savings incentives and enacting Social Security changes, a financial transaction tax, automatic individual retirement accounts, and an employer plan mandate “face a Senate brick wall.” However, some retirement issues could see bipartisan support. They include:

• Multiemployer pension plan reform.
• Funding relief for single-employer plans.
• Examination of retirement tax incentives.

In addition, Manville said that a SECURE 2.0 Act could include:

• Larger catch-up contributions at age 60.
• Matching contributions tied to student loan repayments.
• Enhancements to 403(b) plans.
• Mandated automatic enrollment for new plans.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].