Two documents (brief, detailed) leaked to the press last week provide insight into House Republicans' priorities as they begin to craft a budget resolution and to plan for drafting one or more budget reconciliation bills. In order to achieve their policy goals, House Budget Republicans have identified potential cuts and areas of savings to offset preferred policies. Notably, neither document mentions any retirement-related changes. The relevant proposals are:
- Recapturing excess Affordable Care Act subsidies;
- Repealing the Biden-era ACA "family glitch" final rule;
- Replacing Health Savings Accounts ("HSAs") with a $9,100 Roth-style Universal Savings Account that would be indexed to inflation;
- Passing H.R. 5688, the Bipartisan HSA Improvement Act of 2023, which would allow HSA contributions even if the individual is also participating in a direct primary care arrangement, receiving certain services from an employer's on-site clinic, or covered by a spouse's Flexible Spending Arrangement;
- Ending the Employee Retention Tax Credit for claims submitted after January 31, 2024;
- Eliminating the exclusion for employer-provided meals and lodging;
- Eliminating the child and dependent care tax credit;
- Eliminating employer-paid transportation benefits;
- Eliminating the employer exclusion of on-site gyms;
- Creating a prohibited transaction for employers to pay above the 340B discounted price for 340B drugs;
- Increasing penalties for healthcare providers and insurers under the Lower Costs, More Transparency Act for transparency noncompliance;
- Passing H.R. 2868, the Association Health Plans Act, which would treat Association Health Plans as a single employer under ERISA;
- "Strengthening the ERISA preemption" to "increase revenue by decreasing compliance costs for employer-sponsored health insurance plans;"
- Passing H.R. 2813, the Self-Insurance Protection Act, which would specify that stop-loss coverage is not health insurance coverage for purposes of ERISA;
- Passing H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023, which would allow employers to offer stand-alone telehealth benefits to all employees;
- Expanding "the use of direct contracting and innovative, value-based care models among employer-sponsored insurance plans;"
- Allowing a telehealth-only COBRA option; and
- "Bolstering employer-sponsored health insurance coverage of high-cost specialty drugs, either through value-based arrangements, reinsurance models, or expanded risk pools through association health plans."
Also included are five different SALT proposals on pages 7-8 of the detailed document.
House Speaker Mike Johnson (R-LA) remains optimistic that Congress can send legislation to the president's desk by Memorial Day.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
