The healthcare debate hasn't been as tumultuous this election cycle as it has been in the past, but regardless of who sits in the Oval Office in January, there will be changes in employer sponsored healthcare. Here's what you need to know about potential legislative changes and employee health benefits.
The Democrats
Hillary Clinton:
After years of championing a single-payer system, Clinton shifted her stance to fully support the Affordable Care Act with a plan to extend current legislation. She has stated that building upon the Affordable Care Act is a more practical solution than instituting a single-payer system, but acknowledges flaws in the existing ACA. Notably, high deductibles and premiums. Her plan incorporates increased tax credits to offset high premiums and other out-of-pocket costs. She also plans to "fix" the "family glitch" so that families can make up the gap in costs between employer coverage and health care costs. Under Clinton's plan, little will change for employers but consumers can expect to see relief in the form of expanded public options and tax credits.
Bernie Sanders:
Sanders' position on healthcare is straightforward. He has supported a single-payer health care program for decades. In fact, his home state of Vermont attempted to institute a state-level, single-payer health care program. The plan struggled, in part, because of the increases the plan made to payroll taxes. Some businesses anticipated seeing an 11.5 percent payroll tax increase. His plan would shift insurance responsibilities to a single entity, the government. But employers should expect to see increases in overall tax expenditures.
The Republicans
Ted Cruz:
Cruz has not minced words when it comes to the ACA. If president, he plans to repeal it as soon as he can. He wants to extend low-cost catastrophic coverage for lower-income people and he plans to do so by expanding insurance across state lines. In terms of employer sponsored healthcare, Cruz plans to "de-link health insurance from employment." In essence, it is clear that a Cruz health care plan would free employers of any healthcare sponsorship.
John Kasich:
Kasich also wants to see the end of the Affordable Care Act and envisions a replacement that emphasizes preventative care through patient contact with primary care physicians. In his plan, insurance companies and hospitals would both share profits. In terms of employer sponsored health care, his plan indicates that employers would still retain responsibility for providing healthcare coverage to their employees but with the caveat that his plan would not "impos[e] punishing burdens on job creators."
Donald Trump:
During the February 25th debate, Trump said that he would not "let people die in the street." Though this statement has been taken as supportive of universal health care, he later clarified that he is not in favor of universal health care and plans to end the Affordable Care Act. His plan incorporates free market insurance that is not limited to regional constraints. He indicates that open competition between insurance companies will create market-driven insurance rates that are more affordable for individuals. In addition, his plan stresses the importance of providing individuals with insurance that travels with them across state lines and employers. He also supports health savings plans. Trump does not mention specifically if employers will be expected to contribute to health savings plans, but his statements point in the direction of limited employer sponsorship.
Those Hoping For A Brokered-Convention
Marco Rubio:
As president, Rubio would repeal the Affordable Care Act with a goal of making insurance available to consumers through a refundable tax credit. Under the Rubio plan, employers can expect to see their contributions slowly decrease as employee tax credits rise, in what Rubio calls a "glide path." In other words, within a decade of this declining employer sponsorship, and rising individual health tax credits, individuals will ultimately control their healthcare costs and gain "truly portable health insurance plans that travel with them regardless of where they work."
In Summary
When broken down in terms of the plans that place the most health care responsibility on employers, partisan lines break down and cross in unexpected ways.
- Clinton and Kasich continue to tie health coverage with employment.
- Rubio plans to diminish employer contributions over time
- Trump leaves open the possibility of some employer contributions.
- Cruz and Sanders, on opposite sides of political spectrum, both offer plans that shift healthcare responsibilities entirely from the employer to either the individual or the government.
For more information on navigating these shifting political waters of employer sponsored healthcare, please contact us.