November 26, 2024

Some health care, retirement policies have bipartisan support going into 2025

The incoming Trump administration’s health care priorities are expected to focus on bringing down costs and providing alternatives to Affordable Care Act plans.

That was the word from a panel of analysts from Mercer, who held a webinar on the post-election outlook for benefits policy.

President-elect Donald Trump has been light on benefits policy details, said Geoff Manville, partner with Mercer’s Law and Policy Group. But Trump is expected to revisit some policies from his first term.

Trump is likely to renew efforts to reduce health care costs, expand non-ACA coverage options such as association health plans, and generally support paid leave legislation, Manville said. However, Trump and congressional Republicans are likely to oppose extending enhanced ACA subsidies that are set to expire next year.

“On health care, we don’t see a clear direction with where Trump is going at this point but it will be clearer when he staffs the health policy jobs in his administration,” Manville said, referring to appointing the heads of federal agencies such as the Department of Health and Human Services, the Centers for Medicare and Medicaid Services and the Department of Labor.

Health care affordability is an issue

Health care affordability is one area that has bipartisan support. Manville said both parties want reforms that control costs for employers and consumers. Trump and congressional Republicans are likely to renew their earlier priorities, which include:

Reducing drug costs.
Increasing price transparency and provider competition.
Expanding non-ACA options such as association health plans and short-term limited duration insurance.
Expand and enhance health savings accounts.

Manville noted that Trump also campaigned on requiring employer plans to cover in-vitro fertilization.

While the nation’s eyes are looking at what might happen in Washington in 2025, a backlog of health care issues are awaiting congressional action now and could see some movement in the 2024 lame duck session, Manville said.

Health care reforms that have bipartisan support and could see action this year include:

Pharmacy benefit manager reform. Banning “spread pricing;” requiring disclosures of business practices to plan sponsors and the government; requiring 100% pass-through of rebates, fees and discounts to plan sponsors; requiring PBMs and third-party administrators to disclose direct and indirect compensation to plan fiduciaries.

Price transparency. Codifying rules requiring disclosure of out-of-pocket costs and negotiated rates to plan members and beneficiaries.

HSA modernization. Allowing individuals to convert their own health flexible spending account or health reimbursement arrangement into an HSA

Retirement policy

Retirement policy also is likely to remain a bipartisan issue, Manville said. He predicted Congress will face the following policy issues:

Retirement-related revenue raisers may be in play during the 2025 tax debate. The GOP will need to offset at least some of the $4.5 trillion cost of extending individual tax cuts that expire at the end of 2025.
Bills that would permit 403(b)s to invest in collective trusts and that would correct some provisions in SECURE 2.0 may pass in the lame duck session.
Beginning to lay the groundwork for a potential SECURE 3.0 package.
Next year could see a legislative effort to reverse DOL rules on the use of environmental, social and governance investment factors.
Lawmakers will continue looking at ways to boost the single-employer defined benefit system.

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