Health benefits landscape evolving in Washington

In the first month of President Donald Trump’s administration, a flurry of executive orders as well as memos relevant to employer-sponsored healthcare, retirement and more have raised questions on how employers can remain compliant in a changing benefits world.

“Get your rest while you can this week,” Geoffrey Manville, a government relations principal at Mercer, told HR and benefit executives during a webcast Tuesday. While Congressional leadership has been back home this week, their staff has been busy writing reconciliation legislation on the Hill aimed at dismantling parts of the Affordable Care Act.

“Because provisions have to be budget-related, there are some topics like insurance reforms that can’t be included, and will need 60 votes to pass Senate,” Manville noted. But replacing the healthcare law is going to take a three-bucket approach, he notes.

The first step is producing a reconciliation bill that not only repeals budget-related parts of the ACA, but also includes as many budget provisions as possible, Manville noted.

The second bucket would need to consist of Trump’s administrative actions, such as regulations expected in the coming weeks aimed to stabilize the individual market.

Lastly, there would need to be a series of bills from Congress to replace the ACA that would have to move under regular order.

“Some Republicans like House Speaker Paul Ryan are talking up repairing the ACA, without much difference in terms of actual policy, but Trump and other folks on the Hill are intent on repeal and replace,” Manville said, adding that recently-confirmed HHS Secretary Tom Price now in office could speed up the process.

Meanwhile, there are still questions if the law’s Cadillac tax will be repealed, or if Republicans will wait until tax reform discussions to tackle the employer pain point, Manville added.

And although Trump signed an order on his first day in offices directing agencies to minimize ACA regulatory burdens, Mercer’s Leslie Anderson advises employers to continue planning for ACA reporting for both 2016 and 2017 until they get specific relief. “We don’t know the extent of what the new administration will want on reported information,” she added.

A number of initiatives from Trump intend to lessen regulatory burdens, such as his Jan. 30 order requiring agencies to offset any new rule by revoking two prior rules. “The onslaught of regulations may be over … and won’t be as front and center as they have been,” Anderson said.

Similarly, there has been some substantial activity on the retirement landscape, Mercer said.

Trump’s Feb. 3 memorandum directed the Department of Labor to reconsider the fiduciary rule and revise or rescind it, added Mercer’s Norma Sharara. Although the April 10 deadline to phase in compliance is right around the corner, she said many investment industries have already moved toward compliance, and will remain in line with the rule.

In the meantime, Sharara told employers, “monitor providers with great awareness and proactively manage your vendors, and keep everyone in the loop with what’s going on with the fiduciary rule.”

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