As we close out 2022 and look ahead to 2023, there are a number of trends and milestones in the legislative and regulatory arena that have the potential to impact health care costs for employers and employees alike. Without a crystal ball, it's impossible to say exactly what's to come, but we do have a very good idea of a few things that we should be keeping an eye on.

Rate increases will continue across the board

Some experts predict a 10% increase in overall health benefits costs, but that isn't the whole story. Factors like labor costs, Rx, and supply chain issues also have major implications for the 2023 overall health care spend.

Mental health will (again) rise to the top in 2023

Over the past decade, the use of mental health services by the workforce has skyrocketed. With the continuing impacts of COVID and legislation that has required more transparency and tighter regulations, people have both greater access to, and awareness about the importance of, mental health. But finding practitioners for mental health services continues to be an issue, with extended wait times on appointments and rising Rx costs.

The Family Glitch fix will impact group health plans. But will the long term impact be positive or negative?

In October, the Treasury and the IRS issued final updates amending the Affordable Care Act (ACA) regulations that determine affordability for an employee's family members with regard to employer sponsored health care. These changes are effective beginning with the 2023 tax year and are intended to fix a situation known as the Family Glitch.

Under existing regulations from 2012, the affordability of employer-sponsored coverage for a family member was determined by the affordability of self-only coverage. Depending on how an employer subsidized the cost of family coverage, it was possible that coverage could be considered affordable for the employee, but not for family members. Yet those family members would not be eligible for subsidized coverage on the exchange.

With these amended regulations, family members would potentially be eligible for a premium tax credit in the marketplace, but the employee would not. When families applied for 2023 coverage during the open enrollment period in the fall of 2022, the new rules were used to determine whether anyone in the household qualified for a premium subsidy. Will this lead to more employees with families seeking coverage from the marketplace? That remains to be seen.

Will the insurance industry develop new cost-saving ideas?

While health care is a tightly regulated industry, there is still room for innovation in health insurance and employee benefits. In recent years, we've seen new models emerge for managing costs for both employers and employees.