In the area of health benefits policy, Republicans and Democrats in Congress may be starting to work together to make useful things happen.

The American Benefits Council, a benefits industry group, talks about recent positive developments in a commentary on the new Bipartisan Budget Act of 2018.

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The BBA includes two great provisions, and Republicans and Democrats are teaming up to support a third great provision in a separate, bipartisan bill, the council says.

James Klein, the council’s president, says in a statement that he’s hoping those efforts will help fend off proposals in Congress to limit, or eliminate, the group health benefits tax exclusion.

“Public- and private-sector initiatives that work to better align costs with quality are likely to be much more effective than efforts to eliminate the tax incentives for employer-provided health care,” Klein says.

Here are three helpful developments the council sees today.

1. One section of the BBA will encourage Medicare Advantage program managers to let Medicare Advantage plans use value-based insurance design (VBID) principles.

VBID programs offer richer benefits for the health care that seems most likely to improve the quality of care and lower the cost, and leaner benefits for care that seems likely to increase costs without doing much to improve patients’ health.

James Klein (Photo: American Benefits Council)

James Klein (Photo: American Benefits Council)

Players in the commercial health insurance market say efforts to change Medicare programs and rules can end up changing the commercial market, as well, because Medicare is so big and influential.


2. A second section in the BBA will move toward expanding Medicare Advantage program telehealth benefits.

Holders of health savings accounts (HSAs) must use the accounts in conjunction with high-deductible health coverage. Congress included that rule in an effort to give HSA holders substantial out-of-pocket costs, or “skin in the game,” and to encourage HSA holders to shop carefully for care.

The American Benefits Council has been asking Congress to let employers provide care for employees with HSAs through telemedicine services on a pre-deductible basis, arguing that telemedicine is an innovative, efficient way of delivering care.


3. Republicans and Democrats are joining to reintroduce a bill aimed at HSA holders with chronic conditions.

Today, the Affordable Care Act requires even high-deductible plans to pay for some types of preventive care, including birth control pills, for patients on a pre-deductible basis.

Even today, however, HSA holders who have certain types of chronic conditions must pay for the medications they use to control the conditions with their HSA money, or with other personal funds, not with insurance benefits.

Rep. Diane Black, R-Tenn., is joining to introduce H.R. 4978 with Rep. Earl Blumenauer, D-Ore., in the House.

Sen. John Thune, R-S.D., is joining to introduce a companion bill, S. 2410, with Sen. Thomas Carper, D-Del., in the Senate.

Lawmakers introduced a similar bill in 2016. That version of the bill died in committee.

The American Benefits Council sees passing the new version of the bill as a way to promote efforts to increase support for high-value care.

— Read Lori Lucas to Lead Benefits Data Powerhouse on ThinkAdvisor.


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