While much of the focus in 2018 came down to the elections, we now have those results and can begin moving forward.
But, with a divided Congress, what will the impact be on the health insurance marketplace, the health care delivery system, the advisors and employers that interact (plan, strategize, implement and execute) with health benefits, and, most importantly, the employees that participate in the employer-sponsored benefit plans?
The Policy Landscape
Following the Kavanaugh hearing Sen. Jeff Flake commented that he would have voted differently regarding the FBI investigation if he was running for re-election. This comment paints a picture that our representatives to Congress are concerned with advancing policies that secure their re-election rather than the well-being of their constituents that they represent. With that backdrop, the status quo will be the likely outcome with regard to the current state of the Affordable Care Act (ACA), and America’s group health plans, until the 2020 election.
Are there policies and regulations that the parties could agree on?
(Related: Delay Strategy)
Here are two observations, based on the assumption that members of Congress are thinking about two goals: getting re-elected, and helping their constituents.
First, if there is any change in policy, it could involve a bipartisan approach to addressing prescription drug costs and the impact of prescription drugs on the health and safety of the community. The national discussion around opioids, the increase in drug prices on certain medications, as well as the lack of affordable generic equivalents, are issues that both parties wish to address from a policy perspective.
However, this represents a change on the margins and not a repeal of the program offered through President Obama or the alternative program offered by President Trump. Further, an incremental approach will not have any true and meaningful impact on the cost of health care – which is supposed to be the focus. Rather, the focus will be on insurance or premium reform.
The second observation is that, while the focus has been on health and health care policy — which is really an example of a tremendous expenditure of energy leading to no action — there is not an equal amount of attention being given to regulations for employers and advisors to meet, which come with real economic consequences. For example: Fines and penalties.
What Could Change
So, with no one party in control of Congress and the executive branch, what does the next two years look like? Likely, the parties will be eyeing the 2020 presidential election and one of the key topics will be what the social contract with America looks like.