American Health Policy Institute

As Affordability Reaches Tipping Point, HRPA Urges Congress to Consider Employer Health Care Costs

HR Policy Association and its American Health Policy Institute submitted two separate letters addressing health care legislation regarding end stage renal disease and telehealth flexibilities, underscoring the impact the legislation will have on already increasing employer health care costs. 

Pressure on health care costs: Affordability has already reached a tipping point for employer health care costs. With efforts to attract and retain talent, employers can no longer rely on benefit design cuts to offset the increase in prices. While inflation is already impacting consumers on everyday costs, there will be a lag in how it is felt in the health care industry as employer contracts come up in 2023 and beyond. Legislative activity on Capitol Hill, or lack thereof, has the potential to exacerbate the issue for employers as they try to navigate the coming years and continue providing robust, high-quality benefits for employees and their families.  

The first letter addressed HR Policy concerns around the Restore Protections for Dialysis Patients Act (S. 4750), which establishes additional requirements for employers to comply with the Medicare Secondary Payer Act (MSP). The letter was submitted to Senate Leader Chuck Schumer (D-NY) and Minority Leader Mitch McConnell (R-KY).

  • Currently, employer plans cannot differentiate their benefits provided between individuals with and without ESRD and plans cannot consider whether the individual is eligible for Medicare benefits due to ESRD.

  • The legislation as written states that employer plans would be in violation of the MSP statue if the plan limits, restricts, or conditions the benefits the plan provides for renal dialysis services compared to other chronic medical conditions.

  • HR Policy argued that while well intentioned, the legislation places an unworkable burden on employer plans to conduct parity analyses and eliminates the ability to offer value-based benefit design for those with ESRD and other chronic conditions.

The second letter urges Congress to extend certain telehealth flexibilities granted during Covid to allow inclusion of telehealth as an excepted benefit and to allow employers to provide first-dollar coverage of telehealth for employees under high deductible health plans. HR Policy and AHPI requested that the following flexibilities be extended or made permanent:

  • The Telehealth Benefit Expansion For Workers Act of 2022 (H.R. 7353): In 2020, DOL, HHS and Treasury stated in FAQs that they would not enforce penalties against employers that wanted to offer telehealth services to their employees who were not eligible for the employer-sponsored health plan. This non-enforcement policy ends when the public health emergency expires on October 15, 2022, unless otherwise extended.

  • First-dollar coverage of telehealth for employees under high-deductible health plans: The CARES Act allows employees to receive telehealth services without regard to the individual’s annual deductible as well as allows continued contributions to a health savings account (HSA). This extension is set to expire on December 31, 2022. 

Published on: September 23, 2022

Authors: Margaret Faso

Topics: Federal Health Care Reform, Transparency, Quality and Cost Containment

Margaret Faso

Director of Health Care Research and Policy, American Health Policy Institute and HR Policy Association

Detailed Bio

Contact Margaret Faso LinkedIn


HRPA Highlights Priorities to 118th Congress
Employee Wellbeing

HRPA Highlights Priorities to 118th Congress

January 27, 2023 | News