How will the legislative landscape affect health benefits in 2023?
Published on January 18th, 2023
The regulatory and legislative landscape can greatly affect health benefits, as evidenced by last year’s Roe v. Wade ruling by SCOTUS, which resulted in a myriad of employers having to rethink their benefit offerings. While many legislative changes can be unprecedented, it’s important to keep a pulse on what’s happening to better prepare for (and/or predict) what may be coming.
Before we dive into the current year, it is important to note that at the end of 2022, the U.S. House passed the Consolidated Appropriations Act, 2023, an omnibus spending bill consisting of 12 fiscal year 2023 appropriations bills. This bill extended pre-deductible coverage of telehealth services in a high-deductible health plan (HDHP) through December 31, 2024, and is a win, especially for the middle class. But considering a new Congress, it begs the question – what legislation can we expect to see in 2023 as it relates to health benefits?
118th U.S. Congress
It was hard to miss the highly contentious (and lengthy) process to elect a new Speaker of the House, Republican Kevin McCarthy (R). Here is a high-level look at the House of Representatives:
- Republicans: 222
- Democrats: 212
- Vacant Seat: 1
- Republican Leadership:
- Speaker of the House: Kevin McCarthy (CA)
- Majority Leader: Steve Scalise (LA)
- Republican Caucus Chair: Elise Stefanik (NY)
- Democrat Leadership:
- Democratic Leader: Hakeen Jeffries (NY)
- Democratic Whip: Katherine Clark (MA)
- Democratic Caucus Chair: Pete Aguilar (CA)
What to expect from a Republican-led House?
Following the midterms, the aforementioned lengthy House Speaker vote resulted in delays for swearing in new members and setting up committees.
And this may be just the first headache we will witness in 2023, considering Republicans hold a slim House majority, leading to potential difficulty when it comes to passing legislation. While many have stated the focus will likely be on investigations and oversight hearings, a list of ready-to-go legislative activities was released:
- Family and Small Business Protection Act: Passed
- Select Committee on Strategic Competition Between U.S. and China: Passed
- Strategic Production Response Act
- Protecting Strategic Petroleum Reserve from China Act
- Prosecutors Need to Prosecute Act
- Border Safety and Security Act
- No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act
- Illegal Alien NICS Alert Act
- Born-Alive Abortion Survivors Protect Act
Now that Congress has been finalized and all committee chairs have been approved, a there are a few committees to watch that may affect the health benefits space. In particular we should watch the Committee on Finance as well as the Committee on Health, Education, Labor and Pensions (HELP). The HELP committee will now be chaired by Bernie Sanders (D), who has historically been vocal about the affordability of healthcare. This could be a good sign for health plans, as they can help people afford to pay for health expenses that aren’t covered by insurance.
High-level look at the Senate:
- Democrats: 51
- Republicans: 49
- Democratic Leadership:
- Majority Leader: Chuck Schumer (NY)
- Majority Whip: Dick Durbin (IL)
- Vice Chairs of Democratic Caucus: Mark Warner (VA)/Elizabeth Warren (MA)
- Republican Leadership:
- Minority Leader: Mitch McConnell (KY)
- Assistant Minority Leader: John Thune (SD)
- Conference Chairman: John Barrasso (WY)
What to expect from Congress?
Republicans have traditionally been in favor of Consumer Directed Health (CDH) Care as well as affordability in healthcare. The Affordable Care Act remains under fire, but with the slim Republican majority in the House any efforts to appeal are not likely to gain traction. As reported in many news outlets, any proposed legislation could be met with significant headwinds given the divided Congress.
As in years past, we continue to hope for expansion in HSA eligibility, an increase in the Dependent Care FSA limit, as well as further clarification and enhancements to CDH plans. Only time will tell how these, and other legislative matters, will turn out in the next two years.