Health Care

OVERVIEW

March 23, 2017, marked the seventh anniversary of the massive and complex Affordable Care Act (ACA). More than seven years later, it fails to lower health insurance premiums for hard working Americans and imposes new taxes, as well as costly and burdensome federal mandates on ABC member companies. The ACA continues to create uncertainty and confusion in the construction industry, making it difficult for the nation’s contractors to invest in their future and create jobs for hardworking Americans.

ABC SUPPORTS

• Allowing Americans to buy insurance across state lines. This would be particularly helpful to those who work in the construction industry, as the unique nature of construction work demands that benefits be portable. 
• A tax deduction for the self-employed and for employers. ABC supports raising the self-employed health care deduction to 100 percent and maintaining the tax deductibility of health insurance premiums for all employers. 
Association Health Plans (AHPs). AHPs give small businesses the power to pool together to offer health care at lower prices—something many corporations and labor unions already are permitted to do. 
• Health Savings Accounts (HSAs). HSAs are tax-free savings accounts for medical expenses that allow more small business owners to obtain affordable health coverage for themselves and their employees. ABC supports expanding access to high-deductible health plans and HSAs, as well as increasing HSA contribution limits. 
• Flexible Spending Accounts (FSAs). FSAs, or “cafeteria plans,” allow employees to set aside money (pre-tax) each year to be used for medical expenses such as co-pays, deductibles and services not covered under their base insurance plan. ABC supports repealing the annual dollar limit on employee contributions to an FSA, which is $2,600 for 2017. 
• Wellness programs. For the last several years, ABC members have embraced innovative approaches that encourage preventive healthcare, improve employee health outcomes, and reduce overall health care costs and premiums. These important benefits are increasingly valued by both employers and their employees. Although successful wellness programs are a “win-win” for both the employer and their employees, the Equal Employment Opportunity Commission has issued final rules that would find certain wellness programs in violation of the Americans with Disabilities Act and/or the Genetic Information Nondiscrimination Act, even though they are in full compliance with provisions of the ACA. ABC supports legislative efforts that would ensure that employers can continue to administer wellness programs for their employees without fear of undue government interference or litigation. 
• Medical malpractice reform. Enacting medical malpractice reform would dramatically decrease the cost of health insurance. 

ABC OPPOSES

• Federal government mandates that force employers to offer a certain level of health care coverage or be subject to penalties.
• Tax increases included in the ACA that will continue to hinder reinvestment and job creation in the construction industry.


BACKGROUND

Generally, under the employer mandate provisions of the ACA, employers with 50 or more full-time employees or full-time equivalents must offer a certain level of coverage to full-time employees or be subject to penalties. The increased costs related to this onerous mandate continue to be of significant concern to ABC members.

Providing quality health care benefits is a top priority for ABC and its member companies. However, by forcing employers to offer government-prescribed health insurance, ABC members no longer have the choice or flexibility to structure health care coverage options that meet the needs of their fluctuating workforce. The resulting increased costs jeopardize the ability of ABC member companies to maintain affordable coverage options for their employees and will force some to drop coverage altogether.

In addition to the costly employer mandate, the ACA includes the health insurance premium tax (HIT). Under the HIT, a fee will be assessed on health insurance companies—almost all of which will be passed onto consumers in the fully insured marketplace, where nearly all small businesses and the self-employed purchase their coverage. The HIT will result in the collection of $101.7 billion in the first 10 years. The HIT is expected to cost $101.7 billion in the first 10 years and increase premiums by 2.6 percent in 2018 alone. The Consolidated Appropriations Act of 2016 delayed the HIT for the 2017 calendar year.

UPDATE

On May 4, 2017, the U.S. House of Representatives passed H.R. 1628, the American Health Care Act (AHCA), which would repeal and replace the ACA.  ACA repeal legislation has not passed in the U.S. Senate during the 115th Congress.

On Oct. 12, President Trump signed Executive Order 13813 to expand access to Association Health Plans (AHPs). AHPs are a common-sense solution to lowering the cost of health care by allowing small businesses to join together through bona fide trade associations and purchase health insurance for millions of Americans who have been harmed by the ACA.