By NextBestFitPhase 1: Enactment & build · Step 1.11
Rewrite insurance & benefits law
Effective in stages with each enrollment wave · Congress; DOL EBSA; Treasury; state insurance commissionersDiscuss this step
Amend ERISA, the tax code, and the ACA so that employer plans and private insurance cannot duplicate UHP benefits, and so supplementary insurance is regulated.
Legal vehicle
Universal Health Act, Title IX: amends ERISA §514, IRC §§105, 106, 125, 4980H, and ACA Title I; ends COBRA for health coverage.
Who does it
Congress; DOL EBSA; Treasury; state insurance commissioners
When
Effective in stages with each enrollment wave
In this step
Tasks
6 tasks
Design choice & alternatives
1 decisions with alternatives
Trade-offs
2 pros · 2 cons · 2 trade-offs
Risks
2 risks with mitigations
What changes in the system
10 existing laws, programs, or institutions changed
Other countries
4 comparisons
Biggest risk for this step
Cash-only concierge tier grows. See risks.
Depends on
Nothing: this step can start first.
Steps that depend on this one
Sources: Congressional Budget Office (2024)