America's Benefit Specialist March 2023

NABIP’s LEGISLATIVE PRIORITIES

for the pre-tax payment of an employee’s premiums for em ployment-based health coverage, and enable employers to deduct the cost of health coverage as a business expense. The direct benefits and federal spending offsets of employer- provided coverage result in an annual net social impact of $1.5 trillion, driven by increased labor participation, business formation, increased health coverage and reduced federal health subsidies. Each dollar of federal expenditure—the tax revenue foregone for employer-provided coverage—yields approximately $5.34 in benefits for covered employees and their families, according to the National Bureau of Economic Research. Capping or eliminating the tax exclusion of employer-spon sored coverage for individuals has been seen by some as a way to raise federal revenue and/or offset the cost of other federal reforms or programs. A cap on the exclusion does not address rising medical costs or limit utilization of medical ser vices and will stifle private-sector innovation of benefits and delivery designs. To tamper with the current tax treatment of employer-sponsored coverage would be especially devastat ing to businesses and American workers, which could lead to the highest increase in taxes to middle-class Americans in decades. NABIP strongly opposes capping or modifying the in dividual tax exclusion of employment-based coverage as that would be a direct tax increase on working Americans and their families. PROVIDE EMPLOYERS WITH COMPLIANCE RELIEF FROM BURDENSOME REGULATIONS The ability to offer coverage to employees and the capacity to operate a business for its core purpose are not mutually exclu sive functions. An employer’s offer of coverage is not merely a transaction in which an employee fills out paperwork, enrolls in coverage and receives an insurance card. It is a multifacet ed fiscal and operational commitment at the core of any busi ness. As employers are making the decision to offer coverage and determine which type of coverage to offer their employ ees, the administrative compliance costs and complexities associated with coverage is critical to their consideration. The compliance requirements under the ACA have always been complex and administratively burdensome on employ ers. The workforce changes wrought by COVID-19 continue to further challenge employers. NABIP has long advocated bipartisan legislation to provide a more streamlined approach to the IRS employer infor mation-reporting requirements, the employer mandate definitions of full-time and seasonal employment, and the large-business threshold. The ACA tax policy rules fundamen tally altered business operations and continue to be costly and burdensome. Following the 2022 regulatory actions by HHS, IRS and the DOL to fix the “family glitch,” it is more important than ever

Our Legislative and Regulatory Successes during the 117 th Congress Legislative 4 NABIP supported key provisions in the American Res cue Plan Act that: • extended the employer retention credit previously established by the CARES Act, allowing employers to keep employees on their payrolls and enrolled in employer-sponsored coverage. • extended ACA subsidies to higher-income indi viduals and increased the amount of available subsidies to lower-income individuals, allowing an increase in access to coverage. • temporarily eliminated the ACA “subsidy cliff” and extended tax credits to those with incomes above 400 percent of the federal poverty level for 2021 and 2022. • eliminated the Medicaid drug rebate cap that could have had unintended consequences of increasing drug costs. 4 Following NABIP’s advocacy during our 2022 Capitol Conference, Congress extended the special provision put in place during the pandemic to allow the use of HSA funds for telehealth services from March 2022 to January 1, 2023. • Congress later acted with our support in the 2022 end-of-year omnibus bill to extend this provision through January 1, 2025. This will extend access to care, specifically mental health care. 4 NABIP advocated for the 2020 passage of the 988 system to build on the National Suicide Prevention Lifeline that went live in 2022. Congress designated the hotline, which will build on the National Suicide Prevention Lifeline, an existing network of over 200 crisis centers nationwide staffed by counselors who answer millions of calls each year. 4 NABIP actively negotiated aspects of the Inflation Reduction Act to include: • extension of ACA subsidies previously approved by ARPA • capping Part D out-of-pocket expenses at $2,000 • allowing the HHS secretary to negotiate drug costs for Medicare • capping Medicare insulin costs at $35 4 NABIP actively negotiated aspects of the Inflation Reduction Act to exclude: • lowering the Medicare eligibility age to 60, effec tively creating a public option

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