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Health Plan Provisions in the House Reconciliation Package

On May 22, 2025, the US House of Representatives passed its reconciliation package, now known as H.R.1, One Big Beautiful Bill Act, by a 215 – 214 – 1 vote, advancing an agenda that extends and builds on tax cuts enacted in President Trump’s first term. The bill contains several policies impacting group health insurance plans, health savings accounts, and employer tax credits for paid family and medical leave.

Read more about these proposed policy changes and others in this comprehensive report, which highlights the health-related provisions in the House reconciliation package.




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Paving the Way for More HRAs

President Trump signed an executive order last year directing the Secretaries of Labor, Treasury and Health and Human Services to consider proposing regulations to “increase the usability of HRAs.” This month, the collective departments issued proposed regulations containing changes to the prohibition on pairing HRAs with individual health policies, as well as other changes to the current HRA rules.

Proposed effective date January 1, 2020; comments due December 28, 2018.

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The Budget Act Makes Some Surprising Changes to Benefit Plans

On February 9, 2018, President Trump signed a bipartisan budget deal into law, effectively extending federal funding through March 23, 2018. The act includes multiple provisions affecting employee benefit plans, including relaxed hardship withdrawal rules and relief for individuals affected by the California wildfires.

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American Health Care Act: Considerations for Employers

On Monday March 6, 2017, the House Republican leadership in the Energy and Commerce and Ways and Means Committees unveiled their signature bill to “repeal and replace” the Affordable Care Act (ACA). The “American Health Care Act” (AHCA) is an effort to make good on President Trump’s promise to dismantle the ACA. Democrats are united in their opposition to the AHCA and other stakeholders have also come out against the bill – while the proposed legislation is subject to modification as it is marked up in committee and debated in Congress, certain provisions of the AHCA, if enacted, will be of particular importance to employers and provide the framework for a strategic road map as employers plan and design future health care benefits for their employees.

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Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a proposed rule affecting the individual health insurance market and the Exchanges. While issuers will likely see these actions as encouraging signs of the Trump administration’s willingness to support the Exchanges, these actions do not resolve the political uncertainty regarding the Affordable Care Act’s fate or whether cost-sharing reductions will be funded for 2018. These outstanding questions will likely be a key factor in Exchange stability going forward.

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