With the 2020 presidential election now behind us, employers and employees alike are looking to 2021 and what a potentially new administration will mean for both healthcare and employee benefits. Assuming Joe Biden and Kamala Harris do take office in January, their influence on the healthcare environment will be felt early on.
At the time of this writing, the electoral college had not yet met to make the results of the election official. Furthermore, President Trump was still pursuing the legal options available to him. What you read in the remainder of this post assumes that his efforts fail, and that Joe Biden is inaugurated in January.
Executive Orders on the ACA
As you know, President Trump and the GOP all but neutered the Affordable Care Act (ACA) with their 2017 tax bill. Though they failed to completely eliminate the ACA, they did manage to get a pivotal case to the Supreme Court. No one knows how SCOTUS will rule on that case. But even if they do not strike down the ACA, they are likely to uphold the severability of the individual mandate.
This means employers will likely still be required to offer qualifying insurance under the ACA even though employees are not required to enroll. President Biden is also likely to issue a number of executive orders designed to undo some of what President Trump has done over the last four years. None of his orders are likely to have a significant impact on employer obligations under the ACA.
Addressing Surprise Billing
Both Republicans and Democrats support legislation that would end the practice of surprise billing. Unfortunately, four years of constant bickering has prevented Congress from drafting any meaningful legislation. The bickering is likely to cease in January, or at least be minimized. This suggests Congress could get a bill done very quickly.
Bringing an end to surprise billing should lower overall healthcare costs across the board. It should simultaneously create more competition and lower the out-of-pocket costs patients pay for emergency or out-of-network care.
Addressing Drug Prices
Republicans and Democrats also agree on the need for legislation to rein in drug prices. The Trump administration has even managed to finalize a new rule that reduces the amount Medicare will pay for prescription drugs significantly. Even if the rule does not survive an inevitable court challenge, it is likely that the administration's action will motivate pharmaceutical companies to cooperate with a new administration to lower drug prices.
A New Approach to Coronavirus
Finally, Biden and Harris have already released a seven-point plan to address the ongoing coronavirus crisis. Though one could debate that their plan isn't all that different from what the current administration has done, there are some key provisions worth noting.
For starters, the Biden-Harris plan calls for greater access to free testing. We are likely to see more drive-through testing sites open throughout the country along with a significant investment in home testing kits.
On the prevention front, Biden has stated he plans to work with governors across the country to implement a nationwide mask mandate. The president does not have unilateral authority to implement such a mandate, so Biden would have to rely on cooperation from governors. He is unlikely to get that cooperation from all 50 states, so a true nationwide mandate is unlikely.
The election will affect healthcare and employee benefits regardless of the outcome. For now, all we can do is wait and assume that Joe Biden will prevail. If he does, he will probably begin taking action on the healthcare front right away.