Providing quality health care benefits is a top priority for ABC and its member companies. ABC continues to advocate for policies that would address the skyrocketing costs of health insurance and provide greater choice. The massive and complex Affordable Care Act 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.


  • 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. 
  •  Repeal of ACA taxes on employer-sponsored coverage. ABC supports the Jobs and Premium Protection Act (H.R. 2447 & S. 80) to repeal the health insurance tax under ACA. The HIT is a direct tax on fully-insured carriers which is passed along to the customer – small and mid-size businesses and the millions of hardworking Americans and their families that are enrolled in this type of employment-based coverage. ABC also supports the 2-year HIT delay legislation, the Health Insurance Tax Relief Act (S. 172 & H.R. 1398).
  • Association Health Plans. 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. President Trump signed Executive Order 13813 to expand access to AHPs, which was followed by a proposed rule. 
  • Health Savings Accounts. 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. The House introduced H.R. 5138, the Bipartisan HSA Improvement Act, to improve and modernize HSAs. 
  • Flexible Spending Accounts. 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. 
  •  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. 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.
  •  Protecting Americans from surprise medical billing. Surprise medical billing occurs when insured patients incur unexpected charges after receiving treatment from out-of-network health care providers. ABC has pushed for legislation that would ensure out-of-network costs are disclosed to patients beforehand to protect patients from these burdensome costs.


  • Federal government mandates that force employers to offer a certain level of health care coverage or be subject to penalties.
  • Government takeover of the health care system that would end employer-sponsored health care coverage and impose new tax mandates on employers and employees.
  • Tax increases included in the ACA that will continue to hinder reinvestment and job creation in the construction industry.

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. Under the HIT, a fee will be assessed on health insurance companies—almost all of which will be passed on to consumers in the fully insured marketplace, where nearly all small businesses and the self-employed purchase their coverage. It is estimated the HIT will cost working families $5,000 in higher premiums during the next 10 years.  While the HIT was in effect for 2018, the continuing resolution passed by Congress and signed into law in January 2018 suspended the HIT for 2019.