What Lame Duck Congress, Biden Presidency Could Mean For Health Care

By Susan Rupe InsuranceNewsNet

While the nation continues to wait for a winner to be declared in the presidential race, what we do know is that whoever is elected won’t have a clear mandate to accomplish his policy goals, and that includes health care.

That was the word from Geoff Manville, senior director of government relations at Mercer, who was among the presenters at a webinar on what the election means for health care.

The majorities in the Senate and House of Representatives will hold thin margins, which means bipartisanship will be needed in order to pass any legislation, Manville said.

He added if Democratic candidate Joe Biden is declared the next president, his priorities will be getting his Cabinet appointees confirmed and getting a COVID-19 relief package passed.

Congress will return to Washington next week for its “lame duck” session with its main goal to pass COVID-19 relief. As for health care, Manville said, some possible issues Congress could take up in the final weeks of 2020 include:

Enhancements for flexible spending arrangements.
A reinsurance program for certain costs related to COVID-19 incurred by employer plans.
Expanded emergency paid leave requirements.
Enhanced employee retention tax credits.
Credit equal to 50% of employer costs for back-to-work expenses including testing.
Broad COVID-19 liability protection for employers.

As for Biden's health care agenda, Manville said, his priorities include:

Preserve and build on the Affordable Care Act.
Add a public option.
Lower the Medicare eligibility age to 60.
End surprise medical bills.
Allow Medicare to negotiate drug prices.
Use antitrust laws to address provider consolidation.
Reinstate nondiscrimination protections in health coverage based on gender, gender identity and sexual orientation.
Expand access to contraception services.
Enforce mental health parity rule.

As for building on the ACA, Biden’s plan would make a number of changes to the law, according to Tracy Watts, Mercer’s national leader for U.S. health care policy. Those changes include:

Basing tax credits on the gold plan instead of the silver plan.
Eliminating the threshold for receiving tax credits to buy coverage. Currently, that threshold is 400% of the federal poverty level.
Bringing down the affordability threshold to 8.5% of annual income from the current threshold of 9.83%.

The Supreme Court will hear arguments Nov. 10 in a case that could determine whether the ACA is unconstitutional. At issue before the court is whether the law’s individual mandate is unconstitutional based on the penalty for not having coverage reduced to $0 and whether the entire ACA is invalid if the individual mandate falls. Wade Symons, national leader of Mercer’s regulatory resources group, said a court decision is not expected until spring 2021 at the earliest.

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.