More than 50 years after the Employee Retirement Income Security Act (ERISA) was signed into law, a House hearing Sept. 10 delved into ways to protect and improve the legislation.
Expert witnesses emphasized the importance of the law and legislation they think would bolster the underlying strength of ERISA. Lawmakers and witnesses approved of ERISA preemption, which overrides state laws and allows for uniform health benefits standards.
“However, ERISA preemption is under assault as states seek to impose their own requirements on self-funded group health plans,” said Ilyse Schuman, senior vice president of health and paid leave policy at the American Benefits Council, during the House Committee on Education and the Workforce hearing. “Without ERISA uniformity, these plans these plans would be extraordinarily difficult to administer, forcing employers to offer different benefits to their employees based on their location.”
Schuman also stated her opposition to anticompetitive contracting terms in contracts with health plans and third-party administrators as well as support for price transparency provisions in the Lower Costs, More Transparency Act, a prospective bill that has stalled in Congress.
Families USA Executive Director Anthony Wright called on Congress to expand protections under the No Surprises Act so the legislation includes individuals in self-insured plans, covers unexpected ambulance bills and require large employers to offer the same essential health benefits as small employers.
These advocates stressed to House members that the relationship between insurers and small employers should be smoother and less complex. The average cost of insurance plans has increased 112% over the last 20 years for small employers, and deductibles in those policies have increased 194%, noted Holly Wade, executive director of the National Federation of Independent Business.
An interesting exchange between Eric Burlison, R-Missouri, and Paul Fronstin, director of the Employee Benefit Research Institute, pertained to individual coverage health reimbursement arrangements (ICHRA).
Burlison asked whether there are opportunities in the marketplace where employees can shop for the insurance they need without coverage being directly connected to employment status. He compared it to IRAs and 401(k)s replacing the popularity of pensions.
Fronstin replied that ICHRAs can serve that role, but less than a million individuals are in ICHRA arrangements. Burlison was unaware ICHRAs are an option for businesses, underlining the educational push still needed to push toward widespread ICHRA adoption.
Democrats chose to highlight healthcare elements of Project 2025, the Heritage Foundation blueprint for a Republican administration that is closely tied to former officials in the Trump administration. Donald Trump has since denied reading or supporting the document.
Among those proposals: eliminating the Medicare drug price negotiation program through the Inflation Reduction Act, restricting rights to contraception and birth control and the repeal of the Affordable Care Act.
Republican committee Chair Bob Good, R-Virginia, chose to start the hearing by playing a collection of video clips intended to show Vice President Kamala Harris flip-flopping on previously supporting Medicare for All. Democrats during the hearing criticized the maneuver and called it politically motivated.