Regardless of which way the U.S. Supreme Court decides about health care subsidies under the Patient Protection and Affordable Care Act (ACA), lawmakers need to act now to improve the law, says American Benefits Council President James A. Klein.

The council has issued a package of legislative recommendations to improve health care law. “If the Supreme Court strikes down the availability of subsidies, Congress may believe that is the only issue to be addressed. If the court upholds the subsidies, Congress might conclude that it is ‘business as usual’ and take no action. In fact, several aspects of the Patient Protection and Affordable Care Act require legislative attention now to preserve employer-sponsored health coverage,” Klein asserted in a statement.

The council is urging Congress to:

• Expand health reimbursement arrangements (HRAs) to allow employers to fund an account that employees could use to purchase individual coverage inside or outside the exchanges;
• End the 40% tax on high-cost coverage (the so-called “Cadillac plan” tax), which the council says is pushing employers to take dramatic measures to avoid it;
• Modify the employer “Shared Responsibility” requirement to relieve some administrative costs and burdens on employers that the council says create disincentives for employing “full-time employees” as defined by the law;
• Simplify the significant new and complex employer reporting requirements to the Internal Revenue Service (IRS);
• Repeal the requirement that employers automatically enroll new full-time employees in health plans, which is the council says is unnecessary since virtually everyone is legally required to have coverage and which, ironically, can have adverse consequences on employees’ eligibility for premium tax credits and cost-sharing reductions; and
• Improve health savings accounts (HSAs), including clarification that certain prescription drugs are preventive care that may be covered before an employee has satisfied his or her deductible, and clarification that employers may provide care at on-site medical clinics free of charge without first requiring an employee to meet his or her deductible.

“Even if the U.S. Supreme Court upholds the availability of subsidies in federal exchanges, the urgency to address these other challenges to employer-sponsored coverage will remain. This is the time for action,” Klein concluded.