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And the nominee for Treasury Secretary is … Steven Mnuchin, producer of the Lego Movie, American Sniper, and Rules Don’t Apply. But “producer” is a recent addition to the resume of Wall Street-insider Mnuchin, who spent 17 years at Goldman Sachs before starting his own hedge fund. He also led a group that bought failed subprime lender IndyMac at a bargain-basement price in 2009 and renamed it OneWest. Regulators questioned OneWest's aggressive foreclosure practices, and the bank was one of many that agreed to pay millions in fines to compensate customers. He has not held a public office, but served as Trump's national finance chairman toward the end of his campaign.

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With adoption of a fiscal 2017 budget plan on January 13, Congress has taken the first legislative step toward achieving Republicans’ plan to repeal much of the ACA under fast-track budget rules. The plan, or “budget resolution,” instructs House and Senate committees to write budget “reconciliation” legislation by a non-binding January 27 deadline that knocks out key parts of the law. GOP leaders aim to put a bill on incoming President Trump’s desk within weeks, but the timing and shape of a repeal measure -- and replacement legislation that's taken on new urgency -- is unclear amid party differences over legislative process and policy details. 

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Linda McMahon has entered the ring as President-Elect Trump’s choice to run the Small Business Administration, having spent many years at the helm of World Wrestling Entertainment, Inc. (WWE). McMahon and her husband, Vince, took over the company from his father in 1982, and “helped [it] grow … from a modest 13-person operation to a publicly traded global enterprise with more than 800 employees in offices worldwide,” according to a Trump statement.

 

As President and later CEO of the company, McMahon was involved in all aspects of the business, from contract negotiations to merchandise development to social responsibility programs. McMahon resigned from WWE in 2009 to run for public office, losing two senate races in her home state of Connecticut in 2010 and 2012.

 

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This week the Senate took the first step toward repealing the ACA. Here’s what you need to know:

 

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Much has been written recently about President-Elect Trump’s nominee for Secretary of Health & Human Services, Rep. Tom Price (R-GA). A former orthopedic surgeon from suburban Atlanta, Price has served six terms in the House and is currently Chairman of the House Budget Committee. A recent article in The Washington Post reports Congressman Price "got into government to get government off his back."  

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Since the Presidential election, many have commented on expected legal and regulatory changes. One of them being  prescription drug pricing. It seems that Republicans and Democrats can all agree on the need for more transparency into the cost of drugs. As far as doing something to lower the cost, initially it seemed that with Republicans dominating both Congress and the White House, we might not see much action in this area. But Trump made it clear in his press conference yesterday that he plans to go after drug costs. While no specific plan has been announced, relief for rising drug costs would be welcomed by employers -- provided that pressure applied on Medicare drug costs does not mean cost shifting to private payers. We are keeping close tabs on this issue.

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A few weeks ago, President Obama signed the 21st Century Cures Act into law, allocating $6.3 billion in new spending over the next decade on medical innovation, including $1.8 billion for cancer research.  The bill also streamlines the approval process for new drugs and medical devices and includes support for Electronic Health Records, precision medicine, interoperability, and mental health. 

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Earlier this week, we posted a challenge to our readers to find the 17 Star Wars references in the blog post below. You may have noticed the first reference ("There Is Another...") in the headline. Check out the others below.

 

As the winter weather is finally upon us (can someone say brrr!) cold and flu season also strikes back this time of year, causing many employees to take time off to seek care.  Some employees may want to rush to their nearest doctor to make sure they’ve gotten their flu shot, while others may try to be a trooper and just hope to avoid any illness this season. Holiday travel in crowded airports increases your odds of getting sick, especially if you make your return on the redeye and don’t get enough rest to boot! Getting an end of year appointment can be a menace, but employees have a new hope with retail health clinics. A long time ago, these may have been met with luke-warm reception, but now the retail health market is stronger than you could possibly imagine; many CVS and Walgreens stores operate these clinics, so they’re probably not far, far away from your home or office. Most clinics have a computer kiosk where you can enter your insurance information upfront and get an appointment time; some locations will even send you a text letting you know you’re next patient - advances in e-health sure has made access to care seem like an e-walk in the park! However, if your retail health clinic can’t provide the services you were looking for, don’t feel you have to go it solo in finding appropriate care.  Employees don’t need to go rogue to find the right doctor; they can utilize health advocacy services, to laser in on specific providers to get the specific care they need.  Employers – be sure to communicate these options to employees, so they can maintain their health and productivity during this season and you can ensure your workforce is with you.

 

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We were saddened today to hear about the loss of Carrie Fisher, best known for her role as Princess Leia in the Star Wars film franchise. As a tribute to the joy she brought us over the years, we’ve prepared a Star Wars themed challenge for our readers. Try to find all 17 Star Wars references below -- ask a fan if you need help! Then be sure to check back later this week -- the answers will be posted on Friday.

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GOP’s ‘Obamacare’ repeal path worries health care industry

Ricardo Alonso-Zaldivar, AP (Published by The Washington Post)

  • Don’t overlook the concerns raised by key healthcare industry stakeholders. Within the healthcare system nothing happens in isolation, and repealing and replacing the ACA will certainly have an impact on employer-sponsored plans. *A must read*

 

An Obamacare ‘Delay’ Plan Could Backfire

Margot Sanger-Katz, The New York Times

  • The Republican’s ACA repeal and delay plan assumes the sustainability of the current healthcare system while they put a replacement plan in place. This article questions that assumption and warns that even a carefully planned delay may result in an unintentional quick repeal for some Americans. *Worth the time*

 

Why It Will Be Hard To Repeal Obamacare

Haeyoun Park and Troy Griggs, The New York Times

  • If your employees have questions about repealing the ACA, give them this link. It’s the simplest explanation that we’ve found. *Quick and easy*

 

Leading Republican proposals signal possible shape of ACA replacement plan

Mercer’s Washington Resource Group

  • House Republican leaders, President-elect Trump, and HHS nominee Tom Price have all have ACA repeal and replace proposals. This article compares the proposals' key features, which offer some indication of what a final ACA replacement plan may look like. *Skim this one* (Mercer Select Intelligence membership required. Not a member? Learn more)

 

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While it’s far from clear where the incoming administration and Congress will land on the “replace” part of “repeal and replace” with regard to the Affordable Care Act, they are signaling interest in promoting the use of health savings accounts by expanding eligibility and allowing funds to be used for more purposes. High-deductible HSA-eligible plans already feature in many employer health benefit programs. In 2016, 21% of all covered employees were enrolled in an HSA-eligible plan. Enrollment has been rising over the past decade as employers -- especially large employers (500+ employees) -- have added HSA-eligible plan choices to their health programs. The threat of the excise tax was a big motivator for employers to move employees into lower-cost plans; while the excise tax may go by the wayside, there is now discussion of capping the individual tax exclusion for employer-provided health coverage, which could still drive cost pressure on employer-sponsored health plans.

 

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Final Department of Labor (DOL) rules require ERISA plans processing disability claims to treat coverage rescissions like benefit denials, impose more detailed denial notices written in a "culturally and linguistically appropriate manner," and expand claimants' response and litigation rights. The new rules generally apply for claims filed on or after Jan. 1, 2018, but transitional notice requirements apply for claims filed from Jan. 18, 2017 -- the final regulations' effective date -- through Dec. 31, 2017. While the new administration or Congress might delay, change, or even try to overturn the disability regulations, employers should still plan their next steps as the rules may remain intact.

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