This section includes legislation and guidance related to the original passage and enactment of the Affordable Care Act, as well as any proposed measures to replace it.

Workplace arrangements like Health Savings Accounts (HSAs), Flexible Spending Arrangements (FSAs) and Health Reimbursement Arrangements (HRAs) give participants more choice with respect to health care decisions and provide incentives for seeking out the most cost-effective care. The Council supports public policy that gives plan sponsors the flexibility to offer these arrangements.

ERISA provides for federal preemption of any state law that relates to an employee benefit plan, with the exception of insurance laws. Beginning in 2017, however, states are permitted to seek "state innovation waivers" under Section 1332 of the Affordable Care Act (ACA), under which federal regulators may waive certain aspects of the health care law. The Council has called for limiting the applicability and scope of these waivers.

Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), workers and their families who lose health benefits, under certain circumstances, have the right to choose to continue group health coverage for limited periods of time. This section addresses the requirements associated with the provision of COBRA coverage.

One goal of health reform has been to lower costs by improving the quality of care. Performance measurement, new payment models and value-based insurance design, which seeks to align patients' out-of-pocket costs with the value of services, can help lower costs and improve medical outcomes.

This section covers enforcement and other matters related to the Mental Health Parity Act of 1996 (MHPA) and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which require parity in health coverage between mental health and substance abuse disorders and physical illnesses.