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Policy Watch - Health Care

An affordable, innovative and efficient health care system is essential to ensuring a productive and competitive U.S. workforce, as well as a better quality of life for all Americans. As the providers of health care coverage to more than 177 million Americans, employers and the plans they provide to employees and their families are the bedrock of the U.S. health care system. Enacted in 2010, the Affordable Care Act (ACA) brought about major reforms in health care coverage in the United States, affecting both insured and self-insured employer-sponsored health care plans.

Although the ACA has expanded access to health insurance for an estimated 20 million Americans and the U.S. uninsured health rate is at a historic low of 8.6 percent, increasing health care costs continue to place a growing burden on individuals, U.S. businesses and the economy.

According to the 2016 Kaiser Health Benefits Survey, the average annual premiums for 2016 for employer-sponsored health insurance are $6,435 for single coverage and $18,142 for family coverage. Each rose 3 percent over average 2015 premium levels. In addition, the U.S. Department of Health and Human Services announced that in 2017 the health insurance premiums on the ACA’s Exchanges are expected to increase an average of 25 percent across the 39 states served by the federally run online market and that about 1 in 5 consumers will only be able to choose health care coverage from a single insurer, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their participation in the Exchanges. The continued increase in health insurance premiums is outpacing both inflation and wage increases, making health care costs one of the primary concerns of chief executives.

Despite the rising cost of coverage and the complexity of the ACA, there is little evidence that employers are planning to abandon health care coverage for their employees. Many organizations are changing health care benefits or turning to other health care design strategies, such as health savings accounts, private exchanges, wellness programs and disease management programs to manage costs. It is important that public policies support the efforts of employers to improve the affordability and quality of U.S. health care.

 

Current Issues

On Monday, March 6, the House Republican leadership introduced legislation, known as the American Health Care Act, to replace tax elements of the Affordable Care Act (ACA).  The American Health Care Act was created under the budget reconciliation process and requirements and is limited in its scope to amend only the tax provisions of the ACA. It does not amend the insurance and the underlying coverage requirements of the ACA. Using this process allows supporters of the American Health Care Act to pass changes to the ACA in the Senate with a simple majority of 51 votes instead of the 60 votes needed to override an expected Democratic filibuster. The American Health Care Act includes a number of key issues of interest to the HR profession and workplace, including a delay of the ACA excise tax on high-value employer-sponsored health benefits. 

Read SHRMs Summary of the American Healthcare Act here

 

The following specific issues are of particular concern to human resource executives and the organizations they serve:

  • The 40 Percent Excise Tax. A number of provisions in the ACA attempt to address the burden of health care costs on employers. Nonetheless, one provision aimed at lowering these costs—namely the 40 percent tax on health care benefits—will have a number of serious, unintended consequences.
    Read Full Issue
  • EEOC Regulation of Employee Wellness Programs. Employer-sponsored health care plans are increasingly implemented to improve employee health and enhance productivity. The ACA allows employers to provide financial incentives to participants in a wellness program of as much as 30 percent (up from 20 percent) of the total cost of coverage when tied to participation in the program. Despite the explicit authorization of incentive-based wellness programs in the ACA, however, the Equal Employment Opportunity Commission (EEOC) has challenged employer wellness programs.
    Read Full Issue 

  • The Tax Treatment of Employer-Sponsored Health Care. According to a report from the Congressional Budget Office and the staff of the Joint Committee on Taxation, one of the largest revenue losses for the federal government is due to the preferential tax treatment of employment-based health care coverage. Under current law, the value of both employer and most employee contributions for health insurance are excluded from employee federal income tax and employer and employee payroll taxes.
  • Read Full Issue
  • Definition of Full-Time. Under the ACA, employers with more than 50 full-time employees are required to provide affordable group health insurance coverage to employees and their dependents or face financial penalties. The ACA defines a full-time employee as an individual who works an average of at least 30 hours per week.  
  • Read Full Issue
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