How benefit managers can navigate open enrollment amid OBBBA

President Trump's One Big Beautiful Bill Act has set a variety of changes in motion for employee benefits. Understanding their impact on both businesses and employees will be a crucial part of short- and long-term decision making for leaders.

Here are some of the main ways OBBBA's tax cuts and spending reform will affect healthcare, retirement, education and more, and what benefit leaders should prioritize as open enrollment approaches.    

Healthcare

Cuts to Medicare and Medicaid will increase employees' need for employer-sponsored healthcare, while permanency to telehealth offerings means increased access to care.

Increased healthcare costs
The law plans to cut $500 billion from Medicare starting in 2026, and nearly $1 trillion in cuts to Medicaid. It's expected that nearly 12 million people will lose healthcare coverage as a result of these cuts. Additionally, a rise in uninsured individuals and a drop in reimbursement will present budget challenges for healthcare providers and hospitals, says Christoph Dankert, chief network officer at value-based Centers of Excellence (CEO) specialty care platform Carrum Health. While the timing is up for debate, private insurers, and thus employers who use them, can expect to see costs increase to close the gap, he says. 

Read the article: How Trump's One Big Beautiful Bill Act will increase employer healthcare costs

Changes to HDHPs
With the passage of the One Big Beautiful Bill Act, Congress has made permanent the safe harbor allowing high-deductible health plans (HDHPs) to cover telehealth and other remote services before the deductible is met.

It may seem like a small technical change in a bill with other large implications for healthcare in the country, but it creates real, practical opportunity, especially for those dealing with high-cost health issues, such as cancer care. As a result, leaders should be rethinking their benefit plans. 

With this safe harbor in place, employers now have the ability to change access, availability, and utilization of critical health services — especially for those with the highest financial and geographic barriers to care.

Read the article: How the One Big Beautiful Bill will impact telehealth coverage for HDHPs

Increased access to preventative care
The national conversation around primary care — for both the private and public sectors — is experiencing a profound shift towards prioritizing value, prevention and outcomes over wasteful spending. This transformation comes at a critical time. Despite the shortage of providers the U.S. is now facing, investment in primary care saves money and leads to better outcomes by reducing the need for costly treatments down the road. 

In fact, recent policy changes are accelerating this shift. With the One Big Beautiful Bill Act signed into law, new opportunities are emerging to enable employers to expand access to direct primary care and telehealth at no cost to the employer's plan members. The combination of learnings from CMMI and payment models enabled by the One Big Beautiful Bill Act provide a blueprint for how employers can deliver high value healthcare to their plan members.

Read the article: CMMI and the One Big Beautiful Bill Act are all in on prevention

Retirement

How Gen Z's retirement needs will change
The Trump administration's One Big Beautiful Bill Act (OBBBA), which focuses primarily on tax cuts and spending reform, was signed into law on July 4, 2025. The act also included a Senior Bonus Deduction, which will offer certain older employees reduced taxable income and tax free Social Security. And while those stipulations don't specifically apply to younger talent in the immediate, Gen Z will be indirectly impacted in the long-term.   

"There are still a lot of unknowns [about the act] that we're all still trying to figure out," says Stephanie Hughes, CEO of Wiss Family Office. "But we know that Gen Z finds the current system confusing, and they're right to think that. There's so much information out there and we've made it so complicated when they just want simplicity."

Read the article: Will Trump's OBBBA make it harder for Gen Z to retire?

Impact on Social Security
The Trump administration has claimed that the recently passed tax and spending bill "delivers on President Trump's promise of no tax on Social Security." Experts say it's not that simple.

White House and Social Security Administration officials have framed the new deduction as an elimination of taxes on Social Security benefits — a campaign promise made by President Trump — but experts point out that the new deduction can be used by seniors on any income, not just Social Security benefits.

The deduction will have no impact on roughly half of all beneficiaries, who already pay no taxes on their benefits, according to the Center on Budget and Policy Priorities. Tax-paying beneficiaries who fall under the deduction's income limits would also not see any benefit if they are younger than 65.

Read the article: Trump's new law cuts both ways for Social Security beneficiaries

Education

Student loan scares and education savings stimulants 
Whether someone is a recent college graduate or funding their or a relative's future learning, there are education-based employer offerings that can improve their financial and professional wellness. Upcoming changes to employer student-loan assistance and 529 education savings accounts under the One Big Beautiful Bill Act (OBBBA) could give benefit leaders the opportunity to make their current plans even more appealing.

These employee benefits will also be increasingly necessary, as the Trump administration seeks to shut down former President Biden's SAVE plans, which impacts nearly 7.7 million borrowers, and is also placing limits on student loan options for low and middle-income earners. 

Read the article: How Trump's new law overhauls student loans and 529s for benefit managers 

The open-enrollment process

Higher enrollment rates and an increased need for voluntary benefits
In July, the Trump administration signed into law the One Big Beautiful Bill Act (OBBBA), which focuses primarily on tax cuts and spending reform and affected funding to many public services such as Medicaid, Medicare, the Supplemental Nutrition Assistance Program and the Children's Health Insurance Program. These changes will have sweeping repercussions for employees everywhere, and will be reflected in the way they enroll in their benefits this year.     

"The most important thing is to be as transparent as possible with messaging around who is being affected, what is being affected and how these changes are going to impact those affected," says Katie Carroll, benefit administration provider Empyrean's senior director of Go To Market. "Clear, thoughtful communication has always been important with benefits, but especially now." 

Read the article: How Trump's OBBBA will impact open enrollment

State-specific changes 
If federal benefits are cut if and when the One Big Beautiful Bill becomes law, states will need to take on more financial responsibility. This leaves benefit managers with a dispersed workforce — or who may have one in the future — left to understand how each state's guidelines are affected, and the impact this has on their employees living there. Finding a vetted third party vendor like Sunny Day Fund that understands state-by-state guidelines can make setting up financial wellness options infinitely easier, and allows employers to approach planning and decisions with growth in mind, says its CEO, Sid Pailla.

Read the article: How Trump's One Big Beautiful Bill could boost benefits enrollment