Voters lock state benefits regulation trends in
As the results turn Washington upside down, state capitals are purring along.
The results of Tuesday’s elections changed control of the White House and the Senate but left the key state-level insurance and benefits players the same, according to Patrick Hughes, a partner at Faegre Drinker.
Faegre Drinker is one of the most active law firm’s in the state insurance and benefits legal services markets.
“From the perspective of insurance regulation generally, the statewide election results couldn’t have been more stable,” Hughes said in an email interview. “We’ll have some new voices, but every incumbent elected insurance commissioner and governor won, and every open seat race saw the incumbent party keep control.”
Some insurance commissioners may come, and some may go, “but the election won’t be as big a driver of regulator change as Election Day typically would be,” Hughes said.
A Faegre Drinker consultant, Tricia Beckmann, predicted that the election results mean that the group health regulation trends shaping her work will stay the same.
Many states are working to tighten pharmacy benefit manager regulations and improve enforcement of laws that require insurers to cover mental health care about the same way they cover other forms of health care, Beckmann said.
In addition to changing PBM rules and enforcing mental health parity requirements, some states are ramping up “market conduct” exams, or efforts to make sure that insurers are treating employers, patients, health care providers and other market players properly, Beckmann said.
She believes that some states would like to expand small employers’ access to association health plans, or groups that let small employers and individuals team up to buy coverage that might have lower premiums due to the plans avoiding some of the state or Affordable Care Act requirements that would normally apply to fully insured group plans.
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But AHP access expansion could depend mainly on moves by Congress to change provisions in Employee Retirement Income Security Act that affect AHP programs, Beckmann said.
“One of the big unknowns that will continue to play out in the courts and with future state laws is the limits of ERISA preemption,” Beckmann said.
She sees ERISA preemption questions coming up the most often when states try to add plan design and pharmacy benefits regulations.