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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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IRS Releases 2026 Limits for HSAs and Excepted Benefit HRAs

On May 19, 2025, the Internal Revenue Service (IRS) released Internal Revenue Bulletin 2025-21. It includes Revenue Procedure 2025-19, which provides the 2026 inflation-adjusted amounts for health savings accounts (HSAs) as determined under Code § 223, as well as the maximum amount that may be made newly available for excepted benefit health reimbursement arrangements (HRAs) under Code § 54.9831-1(c)(3)(viii). Revenue Procedure 2025-19 is effective for HSAs for the 2026 calendar year and for excepted benefit HRAs beginning in 2026.

Learn more about other new IRS guidance in this Weekly IRS Roundup published by McDermott’s Tax Group.




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Trump Administration Takes Steps to Enhance Healthcare Price Transparency

In May, the Trump administration issued guidance and requests for information (RFIs) to enhance healthcare price transparency, focusing on both hospitals and health plans. For hospitals, the guidance reiterates the need to provide actual dollar amounts for payer-specific negotiated charges in machine-readable files (MRFs) rather than percentages, and it seeks input on improving the accuracy and completeness of MRF data. For health plans, the RFI addresses concerns about file size and data integrity, and it explores the implementation of net prices for covered prescription drugs, indicating that the administration plans to issue revised schemas and may pursue further transparency rulemaking.

Read more here.




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One Big Beautiful Bill Act Has Compensation & Benefits Impacts for Nonprofit Health Systems

The US House of Representatives passed its One Big Beautiful Bill Act on May 22, 2025 (the Act), but nonprofit health systems may not find much about the Act that’s attractive. If passed by the US Senate and signed into law, the Act would threaten already thin operating margins at nonprofit hospitals and health systems by expanding the executive compensation excise tax, taxing parking, and similar employee benefits.

Read more here.




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“Big, Beautiful Bill”: Federal Tax Bill Would Restrict the Employee Retention Credit

A new federal tax bill under consideration in the US House of Representatives proposes major changes to the Employee Retention Credit (ERC), including disallowing claims made after January 31, 2024 – even if they were filed before the official deadlines in April 2024 and 2025. It would also extend the Internal Revenue Service’s statute of limitations for assessing ERC-related amounts to six years, raising uncertainty for taxpayers with pending or previously approved claims.

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Enforcement of Mental Health Parity Regulations Suspended: Takeaways for Plan Sponsors and Health Insurance Issuers

Enforcement of the 2024 final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) has been suspended due to litigation by The ERISA Industry Committee. In response, the US Departments of Labor, Health and Human Services, and Treasury announced that they will not enforce the new rule until the case is resolved, plus an additional 18 months.

The suspension provides temporary relief from several burdensome requirements in the 2024 Final Rule, such as the “relevant data requirements” (which generally required parity in outcomes), the controversial “meaningful benefit” test, and fiduciary certification mandates. However, plan sponsors must still comply with MHPAEA’s core obligations and the requirements of the Consolidated Appropriations Act, 2021, including the written nonquantitative treatment limitation comparative analysis.

Learn more here.




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New EO Targets Prescription Drug Costs – and Drug Manufacturers, Hospitals, and Health Centers

On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives designed to reduce drug prices and improve access for US patients. Of particular note for sponsors and providers of employer health plans, the EO tasks the US secretary of labor with proposing regulations to improve employer health plan fiduciary transparency into direct and indirect compensation received by pharmacy benefit managers.

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IRS Announces 2026 Limits for Health Savings Accounts, High-Deductible Health Plans, and Excepted Benefit HRAs

The Internal Revenue Service recently announced cost-of-living adjustments to the applicable dollar limits for health savings accounts, high-deductible health plans, and excepted benefit health reimbursement arrangements for 2026. All of the dollar limits currently in effect for 2025 will change for 2026, with the exception of one limit.

Read more here.




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The Employee Retention Credit: IRS’s “Risking” Model Faces Legal Challenge

In April 2025, the US District Court for the District of Arizona rejected a motion for a preliminary injunction filed by two tax preparation companies. These firms aimed to stop the Internal Revenue Service from using an automated “risk assessment model” to evaluate and reject Employee Retention Credit (ERC) claims, seeking to reinstate individualized reviews of ERC claims.

Read more here.




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PBMs Score a Win in Federal Court Against State Regulation

A recent federal court decision in McKee Foods Corp. v. BFP Inc. declared that Tennessee’s “any willing pharmacy” requirement was preempted by the federal Employee Retirement Income Security Act of 1974. This decision impacts self-funded group health plans, potentially allowing them to comply with a single set of rules nationwide rather than navigating conflicting state laws.

Read more here.




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