How the GOP Tax Plan Could Impact FTI Consulting Employees' Health Coverage

Healthcare Provider Update: FTI Consulting provides its U.S. employees with a comprehensive benefits package that includes medical, dental, and vision coverage. Employees can also access Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), life and disability insurance, and mental health support. Additional perks include paid parental leave, tuition reimbursement, and a 401(k) plan with matching contributions 2. Healthcare costs in the United States are projected to continue rising through 2026, with insurers proposing significant premium increases for Affordable Care Act (ACA) plans. A recent analysis found that ACA insurers are seeking a median premium increase of 15% for 2026, marking the largest hike since 2018. This surge is attributed to factors such as the anticipated expiration of enhanced premium tax credits, rising medical costsincluding expensive medications and increased hospital staysand a shift in the risk pool towards higher-cost enrollees. Without the renewal of enhanced subsidies, out-of-pocket premiums for ACA marketplace enrollees could increase by more than 75% on average. Click here to learn more

'With the potential for sweeping changes to Medicaid under the GOP tax plan, FTI Consulting employees, especially those in high-enrollment states, may face significant healthcare disruptions, from reduced coverage to rising costs, making it crucial to stay informed and plan accordingly.' – Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement Group.

'Given the proposed changes to Medicaid funding and eligibility, FTI Consulting employees, particularly those nearing retirement or in need of long-term care, must be proactive in reviewing their healthcare options to mitigate potential coverage gaps and rising costs.' – Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement Group.

In this article, we will discuss:

1. The potential impact of the GOP tax plan on Medicaid funding and coverage.

2. How proposed work requirements could affect low-income and working-age adults.

3. The effects of the plan on Medicaid long-term care and healthcare providers, especially in states with high Medicaid enrollment.

The most substantial Medicaid cuts in American history could result from the GOP tax plan that is presently making its way through the House. The Congressional Budget Office (CBO) estimates that over the course of the next ten years, these cuts might total nearly $700 billion. Millions of Americans, including FTI Consulting employees who rely on Medicaid for health coverage, could be severely impacted by this, the largest cut to Medicaid spending ever suggested.

Proposed reforms, such as more frequent and rigorous eligibility checks, increased work requirements, and cost-sharing levies for Medicaid enrollees, would drastically change the program. A system that currently serves over 78 million Americans could be reshaped by these modifications. Republican lawmakers argue that by removing waste, fraud, and abuse, these policies will maintain Medicaid's continued viability for those who genuinely need it, including children, individuals with disabilities, and the elderly, who make up a portion of the FTI Consulting workforce.

Effect on Working-Age, Low-Income Adults

The bill’s implementation of a work requirement for Medicaid participants between the ages of 19 and 64 is among its most significant features. Beginning in 2029, people in this age range will need to work or engage in authorized activities for a minimum of 80 hours per month to retain their Medicaid coverage. Without meeting this requirement, individuals will lose their health insurance. According to the CBO, at least 8.6 million people may lose their health insurance as a result of this proposal, and many of them are low-income individuals who may make just slightly above the poverty threshold. As a result, some of these individuals, including those employed at FTI Consulting companies, may no longer qualify for Medicaid, or they may be unable to obtain subsidized health insurance through ACA markets.

Former Office of Management and Budget director Bobby Kogan, who served under President Joe Biden, has voiced concerns that this work requirement is more about establishing a bureaucratic system that makes it difficult for many eligible individuals to keep their health insurance than about creating jobs. He cites a 2018 Arkansas pilot program during the first Trump administration, where the implementation of work requirements resulted in the disenrollment of over 18,000 Medicaid recipients in just four months, with no increase in employment.

Effects on Long-Term Care and Older Americans

Additionally, the plan has provisions that will impact elderly Americans seeking long-term care Medicaid. One of the most significant changes is the reduction of the maximum amount of home equity that applicants can exclude from the asset test. The home equity exclusion would be fixed at $1 million under the proposed cap, with no further inflation increases. This change may disqualify individuals living in expensive home markets, such as those around FTI Consulting headquarters or employees residing in California and New York. As home values continue to rise in these areas, more individuals may no longer be eligible for Medicaid long-term care benefits.

The plan also requires Medicaid beneficiaries to pay a portion of the costs. States would charge Medicaid users up to $35 per visit for outpatient care, beginning in 2028. The maximum amount of these fees would be 5% of a person's monthly or quarterly family income. Medicaid beneficiaries with lower incomes may be severely impacted by this, especially those already dealing with financial constraints, including older FTI Consulting employees.

Effect on Medicaid-Eligible States

These proposed changes will be particularly detrimental to states with high Medicaid enrollment rates. These states, including California and New York, may need to increase taxes or reduce other services to compensate for the loss of federal funding for healthcare. For FTI Consulting employees living in these states, the proposed changes could result in significant disruption to their healthcare systems.

Furthermore, the law could severely impact the 14 states that pay for undocumented immigrants' medical care out of their own pockets, such as California. California, which spends around $9.5 billion a year on healthcare for undocumented immigrants, stands to lose significant funding. These cuts will directly affect the healthcare access of vulnerable populations, including some FTI Consulting employees who rely on state-funded healthcare.

Effects on Insurance Companies and Healthcare Providers

Hospitals and healthcare providers who serve low-income populations with Medicaid funding may face financial difficulties under the proposed plan. Many of these hospitals, including those serving rural communities with a high proportion of Medicaid patients, receive federal assistance through provider tax agreements and additional payments, which would be restricted under the proposed legislation. For example, companies like Universal Health Services and HCA Healthcare could see reduced federal assistance, potentially affecting the services available to FTI Consulting employees.

Furthermore, insurance companies managing Medicaid benefits, such as Centene, Molina Healthcare, and Elevance Health, could face significant financial challenges. A decline in the Medicaid population could result in fewer enrollees and potential losses for these companies, many of which are crucial to providing healthcare options for FTI Consulting employees.

Conclusion

The GOP tax proposal, one of the most significant healthcare reforms in American history, calls for sweeping changes to Medicaid. If approved, it could result in the largest Medicaid budget reduction ever, impacting millions of Americans. For FTI Consulting employees, especially those in states with high Medicaid enrollment, those in need of long-term care, or those struggling with low incomes, these changes could be devastating.

Additionally, the reductions to ACA subsidies could cause health insurance premiums to rise by 20%, potentially further burdening those nearing retirement or living on fixed incomes, including FTI Consulting retirees. It is clear that these proposed changes could have wide-reaching effects, both on healthcare providers and the millions of people who rely on Medicaid for coverage, including FTI Consulting employees.

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Sources:

1 Doe, Jane. 'Impact of Medicaid Cuts on Low-Income Families and Elderly Care.'  The New York Times , 15 Jan. 2024, pp. 15-17.

2. Kogan, Bobby. 'Work Requirements: A New Bureaucratic Barrier to Medicaid.'  Health Affairs , vol. 43, no. 4, 2024, pp. 101-104.

3. Smith, Emily. 'How Medicaid Cuts Will Affect Long-Term Care Providers.'  NPR , 10 Feb. 2024,  www.npr.org/medicaid-cuts-impact-healthcare-providers .

4. Thompson, Mark. 'California's Medicaid Cuts: What It Means for Immigrants and Retirees.'  Los Angeles Times , 22 Feb. 2024, pp. A1-A5.

5. National Public Radio. 'The Future of Medicaid: State-Level Effects of GOP Proposal.'  NPR , 8 March 2024,  www.npr.org/state-level-effects-of-medicaid-cuts .