The Facts of the Month

Here is something to mention when the cost of healthcare in the month ahead.

“Each year, actuaries from the Centers for Medicare and Medicaid Services (CMS) project future spending on health. In 2024, per capita health spending growth is estimated to have slowed to 4.5%. Growth is expected to slow further in 2025 and 2026 to 4.2% and 4.3%, respectively.

From 2027-2032, per capita spending growth is projected to moderate at an average annual rate of 5.0%. During this period, national health spending is expected to outpace GDP, partly due to the growth in medical prices. However, the Inflation Reduction Act’s (IRA) Medicare drug price reforms, which begin to take effect in 2026, are expected to put downward pressure on growth during this period.”

Source: Matthew McGough, Aubrey Winger, Nisha Kurani, and Cynthia Cox. “How Much is Health Spending Expected to Grow?” Kaiser Family Foundation. October 7, 2024.

The Big Three

Each month GPAHU identifies three top public policy or legal developments that could impact our members and clients. Here are this month’s big three!

1. Pennsylvania NABIP on the Hill and in Harrisburg

Over thirty Pennsylvania NABIP members will join colleagues from around the country in Washington, DC from February 23-26, 2025 to meet with federal policymakers and advocate for better and more effective healthcare solutions, as well as educate them about the significant impact insurance and benefits specialists have in their community. To learn more about the conference and register to attend click the link below or search Capitol Conference on the NABIP site. –

https://nabip.org/events/list/recurring-events/2025-capitol-conference

Then, a month later, on March 25, 2025, we are asking all of you to join us in Harrisburg for PA-NABIP’s Day at the Capitol. We will be briefing our members on the issues, setting up meetings with legislators, and showing our policymakers the value of health insurance professionals. More details, including registration information, will be forthcoming, but mark your calendars now for this critical event!

2. Legislative Leadership Changes in Harrisburg

The 2024 elections kept the Pennsylvania General Assembly divided by chamber, and as the 2025 legislative session begins, both the House and Senate are determining leadership teams. The GOP controls the Senate by a 28-22 majority, and the Democrats control the House by one vote. Both parties are keeping some of their leaders in place for this session, but there will be some new faces in key roles as well.

On the House side of the General Assembly, business could not begin without a Speaker. Even though Representative Matthew Gergely (D-35) was unable to vote due to a medical emergency, meaning that an equal number of Republican and Democratic lawmakers were present, Representative Joanna McClinton (D-191) was reelected Speaker. The GOP House members will have a new leader this session, having selected Jesse Topper (R-Bedford) to run their caucus in November. The House Insurance Committee will also have a new Chairman, Representative Perry Warren (D-31). Warren has served on the Insurance Committee for several years and is an attorney and small business owner. Representative Tina Pickett (R-110) will remain the GOP Chair.

Over in the Senate, Senator Joe Pittman (R-41) retains his title as Majority Leader and Senator Jay Costa (D-43) will continue to lead the Democratic caucus. However, the Senate Banking and Insurance Committee will have a new Chairman, Senator Chris Gebhard (R-48). Chairman Gebhard was first elected in 2021 and has owned a primarily property and casualty insurance agency in Lancaster for over 20 years.

3. Telehealth HDHP Safe Harbor Expires

Congress failed to extend a temporary telehealth coverage safe harbor for individuals who have both a qualified high deductible health plan (QHDHP) and would like to contribute to a health savings account (HSA) by its December 31, 2024 expiration date. This means carriers and group health plan sponsors will need to make sure that QHDHP plan participants are charged a fair-market value for telehealth visits in the 2025 plan year until they meet their deductible.

During the COVID-19 pandemic, Congress enacted legislation both clarifying that telemedicine visits are not considered preventive care for QHDHP purposes, and granting a temporary reprieve to this ruling so that QHDHP beneficiaries could receive first-dollar coverage of telemedicine during the pandemic and still be allowed to contribute to the HSAs. However, Congress failed to include an extension or a permanent fix in the end-of-the year funding measure.

While NABIP will advocate for Congress to pass a retroactive fix in 2025, for now, brokers should make sure that any clients with QHDHP plans in place for 2025 update their plan designs and all related plan documents, including the summaries of benefits and coverage (SBC) given to plan participants during open enrollment and summary plan descriptions (SPDs).

Check This Out!

If you want to expand your health policy knowledge beyond this newsletter, here is a resource to check out!

Explore the status of state legislation to address prescription drug costs using the map and charts developed by the National Association of State Health Policy.