Some health care laws could pass Congress despite leadership turmoil

Turmoil in the U.S. House of Representatives has dimmed prospects for passing health care legislation this year. However, there is also a lot of momentum in Congress behind the health policy work that has already been done, so some health care reforms have a chance to build on a large catch-all bill at the end of the year. And laws that don’t cross the finish line this year will be carried over to next year.

That’s what Geoff Manville, a partner at Mercer, said during a recent webinar that reviewed health care law and policy.

The drug pricing reform legislation has bipartisan support in Congress and support from employers, Manville said. But the timing and form of final legislation this year could depend on the need for revenue as part of a year-end package.

Two drug pricing reform bills, H.R. 5378 and S. 1339, target pharmacy benefit managers in the commercial market. The bills aim to reduce costs through greater transparency, competition among providers and billing reforms. Highlights of these two bills include:

• Require new detailed information from PBMs to plan sponsors.
• Require PBMs to pass on all discounts, fee reductions, and other compensation to health plans.
• Prohibit spread prices on the commercial market.
• Require PBMs and third-party administrators to disclose direct and indirect compensation to plan fiduciaries.
• Codify, strengthen and expand price transparency rules.

The Biden administration’s proposals on mental health policies and telehealth could also lead to a new legislative push, Manville said.

The administration proposed a rule that aims to strengthen and strengthen the Mental Health Parity and Substance Abuse Equity Act and seeks feedback on how standalone telehealth could improve access to care mental health and substance use disorders.

The health savings account calls for action

The House Ways and Means Committee passed two bills updating health savings account rules, and Manville said those bills could be part of a year-end mix of legislation .

The bipartisan HSA Improvement Act (HR 5688) would allow individuals to convert their own healthcare flexible spending or healthcare reimbursement arrangements into an HSA, subject to certain limitations and requirements.

The HSA Modernization Act (HR 5687) increases annual HSA contribution limits, allows HSA-eligible spouses age 55 and older to make catch-up contributions to the same HSA, and allows use HSA funds for qualified long-term care services needed by people with chronic illnesses.

The House also passed the CHOICE Arrangement Act (HR 3799), which contains four Republican proposals targeting small employers. The bill, which Manville said faces an uncertain future in the Senate, allows employers to subsidize individual health insurance coverage through individual coverage health reimbursement agreements, expands access to association health plans for businesses and self-employed people, prevents stop-loss insurance from being regulated as health insurance and requires the Treasury Department to notify employers of flexible and advantageous health insurance benefits on the tax plan.

SECURE 2.0, DC projects also in the spotlight

According to Manville, following up on SECURE 2.0 and legislation surrounding defined contribution plan investments is also at the top of the Capitol Hill agenda. Retirement policy is largely moving into the regulatory realm, he said.

Work on a SECURE 2.0 technical corrections bill continues but its timing is uncertain, he said. Lawmakers introduce some planned corrections to the bill while plan sponsors submit their own lists of corrections they want to see.

A bipartisan House bill would allow 403(b) plans to invest in group trusts. The bill, H.R. 3063, was approved by the House Financial Services Committee and its supporters are aiming for a vote by the full House.

Recent legislation begins to set the stage for the next potential reform package, Manville said. The Automatic Re-Enrollment Act (HR 4924 and S 2517) is intended to encourage the adoption of automatic re-enrollment in retirement savings plans. The Employee Lifetime Income Act (HR 3924) would relax rules on annuities as a default option in retirement savings plans. The Womens Retirement Protection Act (HR 2060 and S 2627) requires spousal consent for DC plan distributions.

Susan Rupe is editor-in-chief of InsuranceNewsNet. She previously served as communications director for an insurance agents association and was an award-winning journalist and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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