The American Benefits Council Calls on Congress to Focus on 4 Key Health Policy Priorities
Lawmakers should take “bold steps” to strengthen employer plans, reduce costs, promote telehealth and combat the mental health crisis, wrote the American Benefits Council.1
As a divided Congress prepares to take up healthcare reform once again, the American Benefits Council is urging lawmakers to build on gains made during the pandemic that favor employer benefits plans and support the millions of Americans who receive health benefits at work.1 When the ACA passed in 2010 many feared that Americans would stop enrolling in employer-based plans and turn to the government-controlled ACA marketplace. Now ten years later, that fear has not come true. Instead, companies and employees alike see health benefits as an important feature of employment, with companies often competing to offer the best health plans at the most affordable price.2
“Pursuing healthcare policy reform in a divided Congress is a challenge, but with every challenge comes opportunity,” American Benefits Council Senior Vice President, Health Policy, Ilyse Schuman said. “One clear direction Congress can follow is to strengthen the employer-provided health coverage system that is favored by Americans across the political spectrum and support employers’ efforts to address some of the nation’s most significant health care challenges.”1
Schuman sent a letter to Congress outlining four key areas where legislative action could greatly enhance the ability of employers to offer health benefits that both improve the lives of plan members and offer better care at a lower–or at least a more consistent–cost:1
- Preserve and strengthen employer-provided health coverage
- Lower cost and improve value
- Leverage telehealth to improve access and value.
- Combat the mental health crisis.
The letter sent also included am extensive list of studies supporting these requests with a major cause for concern: the ongoing and rapidly increasing consolidation within the provider industry.1
“In concentrated markets, prices do not flow from competitive negotiations, but from the outsized leverage that market concentration affords. Large hospital systems attempt to leverage their significant market share by forcing plans to contract with all affiliated facilities and prevent educating patients about lower-cost, higher-quality care. These anti-competitive contract terms in the form of “all-or-nothing,” “anti-steering,” “anti-tiering” and “most-favored-nation” contract provisions foster inflated costs and limit plan sponsor’s flexibility in plan design to promote access to high-value care,” the Council stated.1
Other major areas of reform requested by the council: price transparency, both for hospital treatment pricing and prescription drug pricing; removal of barriers to accessing mental health services; better ways to manage and pay for plan members with chronic disease conditions; cost-shifting to employers rather than true cost/price reform; greater access to telehealth services.1
The council noted that the legislative initiative to improve price transparency has been moving forward. But, it said, much work needs to be done.
“Congress can and should take bold steps to address the root causes of rising costs and improve transparency for payers in the system. Any proposal that merely shifts costs to employers should be soundly rejected,” the Council said.1
Employers are in a unique position to create a positive momentum around mental health by implementing impactful programs and building a culture that makes it ok to ask for help.3 The mental health crisis exploded during the pandemic, and its fallout continues to disrupt the workforce. “Employer efforts to combat the nation’s mental and behavioral health crisis must be supported by policies that strengthen the mental health provider workforce; leverage telehealth; increase integration, coordination and access to care; and promote the use of evidence-based behavioral healthcare.”