Obamacare's Twelfth Birthday, How It's Going with Armstrong and Getty

Spent a couple segments on the Armstrong and Gettys show this morning discussing Obamacare's accomplishments after twelve years. 

 

Here are my show notes for those who want to read more on the topic.  

A Litany of COVID Vaccination, Abortion and Gun Legislation Proposed in California

Over the next few weeks, California's legislature will be voting on a myriad of newly proposed laws impacting healthcare, individual rights, and employer responsibility.  Here is a brief summary of some of them:  

From CalMatters:  

Taken together, the adoption of these bills would make California an outlier among states — and give it the country’s strictest COVID-19 regulations. Other states are considering various mandates and legislation related to COVID-19, but none appear to have the coordination of this effort, steered by some of the most powerful legislators in Sacramento.

“These bills all attempt to bring cohesion, consistency and clarity to our overall approach and response to the pandemic,” said Democratic Sen. Josh Newman of Fullerton, a member of the group.

The bills:

• SB 871 would require all children 0 to 17 to get the COVID-19 vaccine to attend child care or school;
• SB 866 would allow kids 12 to 17 to get the COVID-19 vaccine without parental consent;
• SB 1479 would require schools to continue testing and to create testing plans;
• SB 1018 would require online platforms to be more transparent about how information is pushed out to consumers;
• SB 1464 would force law enforcement officials to enforce public health orders;
• AB 1993 would require all employees, including independent contractors, to show proof of COVID-19 vaccine to work in California - defeated on March 29th;
• AB 1797 would make changes to the California Immunization Record Database;
• AB 2098 would reclassify the sharing of COVID-19 “misinformation” by doctors and surgeons as unprofessional conduct that would result in disciplinary action.  

Critics said the bills infringe on the health privacy of children, interfere with how doctors work, impose a burden on businesses and workers, and rely on vaccines that do not in many cases prevent the transmission of COVID-19.

Other legislation on tap in the Golden State:  

• AB 1594 encourages California residents to sue gun makers, distributors of ghost guns, and "assault weapons" if they fail to "enforce reasonable controls, ... and take reasonable precautions to ensure that the [gun manufacturer] does not sell, distribute, or provide a firearm-related product to a downstream distributor or retailer of firearm-related products who fails to establish, implement, and enforce reasonable controls.  The bill would also prohibit a firearm industry member from manufacturing, marketing, importing, offering for wholesale, or offering for retail sale a firearm-related product that is likely to create a substantial and unreasonable risk of harm to public health and safety." 

• Another bill proposed by Assembly Member Scott Wiener of San Francisco, "would render unenforceable in California any out-of-state court judgments seeking to remove children from their parents’ custody because they have received gender-affirming surgeries, hormone therapy, and other transgender medical care." 

• Under SB 1142, taxpayer funds could be spent to help low-income California residents obtain abortions.  More significantly, the fund would be available to help out-of-state residents get abortions as well.  The legislation proposes, " the commission shall not require the submission of any identifying personal information about individuals receiving practical support services as part of an application for a grant [for an aborition] or reporting of expenditures and activities using grant [abortion] funds under this article." 

• In order to "make capitalism more sustainable and humane," U.S. House Representative Mark Takano (CA) has proposed legislation that would reduce the standard workweek from 40 hours to 32 hours. 

Top 10 Most Expensive Chronic Diseases for Healthcare Payers

From  HealthPayerIntelligence: 

The top 10 most expensive chronic diseases for healthcare payers eat up significant healthcare dollars. ...Healthcare spending reached a total of $4.1 trillion in 2020, based upon estimates from CMS. Spending is expected to continue to grow at an average of 5.4 percent through 2025, with chronic diseases treatment comprising a significant portion of that spending. Based on the latest data from the CDC and presented in descending order, here are the top 10 most expensive chronic diseases for healthcare payers to treat.

1. Heart disease and stroke costs in the US total $363 billion per year
2. Diabetes care cost $327 billion in 2017
3. In the US, the total cost of arthritis was an estimated $304 billion
4. Excessive alcohol use cost the US economy $249 billion, or roughly $2.05 per drink
5. Cancer care is estimated to cost $240 billion
6. The United States spends $147 billion on healthcare related to obesity and roughly $117 billion on costs associated with inadequate physical activity
7. Alzheimer's and related dementia, $244 billion
8. Smoking, $225 billion
9. Tooth decay, $45 billion
10. Epilepsy, $8.6 billion

 

California Adopts COVID Sick Leave—Again

California has passed a new version of Supplemental Paid Sick Leave (SPSL) that will take effect on February 19, 2022, and apply retroactively back to January 1, 2022. The law expires on September 30, 2022. The law applies to employers with 26 or more employees. FAQs should be available soon on the Labor Commissioner’s webpage. Below are the key points from the statute.

Employee Eligibility

All employees of covered employers are immediately eligible, regardless of status, hours worked per week, or length of employment.

Amount of Leave

This new SPSL provides two separate banks of leaves: one that employees can access for numerous reasons related to COVID (we’ll call this Standard SPSL) and another they can access only when they or a family member test positive for COVID-19 (we’ll call this Positive Test SPSL).

Full-time employees (as defined by the employer) and those who have worked, or were scheduled to work, an average of 40 hours (or more) over the two weeks before their leave are entitled to 40 hours for Standard SPSL and an additional 40 hours for Positive Test SPSL.

Part-time employees are entitled to the number of hours they are usually scheduled to work in a week. If they have a variable schedule, they are entitled to seven times the average number of hours they worked each day in the previous six months (or the entire duration of employment if they’ve worked less than six months) or, if they have worked for seven days or less, the number of hours they have worked before taking leave. The same calculation applies to their bank of Standard SPSL hours and their bank of Positive Test SPSL hours.

No employee is entitled to more than 80 hours of SPSL between January 1, 2022, and September 30, 2022.

Use of Leave

Employees can take Standard SPSL if they are unable to work or telework because:

• They are subject to a quarantine or isolation period related to COVID-19 according to an order or guidance of a public health authority.
• They have been advised by a health care provider to isolate or quarantine due to COVID-19.
• They are attending an appointment for themselves or a family member to receive a COVID-19 vaccine or a vaccine booster.
• They are experiencing symptoms or caring for a family member experiencing symptoms, related to a COVID-19 vaccine or vaccine booster (for each shot, the employer can limit leave to three days or 24 hours, inclusive of time spent getting the shot, unless the employee provides verification from a health care provider that symptoms are ongoing).
• They are experiencing symptoms of COVID-19 and seeking a medical diagnosis.
• They are caring for a family member who is isolating or quarantining because of COVID-19 according to an order or guidance of a public health authority or their health care provider’s advice.
• The covered employee is caring for a child whose school or place of care is closed or otherwise unavailable for reasons related to COVID-19 on the premises.

Employees can use their Positive Test SPSL hours if they are unable to work or telework because:

• They test positive for COVID-19
• A family member they provide care for tests positive for COVID-19

Employers can’t require employees to:

• Exhaust their Standard SPSL hours before using their Positive Test SPSL hours;
• Use their state-mandated paid sick leave (PSL), vacation, PTO, or any other leave benefit before or instead of using SPSL for a covered reason; or
• Use SPSL prior to providing paid leave under any Cal-OSHA COVID-19 Emergency Temporary Standard (e.g., in lieu of exclusion pay).
• Use a certain amount of leave or use leave when they don’t want to. Employees have the right to choose when to use their SPSL and how much to use.

Rate of Pay

Non-exempt employees should be paid at their regular rate of pay for the workweek during which they use leave. If their rate of pay is not determinable just by looking at the week in question, divide the employee’s total wages (not including overtime or premium pay) by the employee’s total non-overtime hours worked in the full pay periods in the 90 days before they take leave. Exempt employees should be paid at the same rate you pay them for other forms of paid leave.

Employers can limit pay for SPSL to $511 per day per employee and $5,110 total per employee.

Offsetting an Employee’s SPSL Hours

Employers who provided an employee with another form of COVID-specific paid leave on or after January 1, 2022, can count those hours toward the employee’s SPSL entitlement. The leave provided must have been available for a reason covered by SPSL. The offset does not apply if an employee used their state-mandated paid sick leave (PSL), PTO, vacation, or other non-COVID leave.

There are two likely scenarios where an offset will apply: If an employer is voluntarily providing COVID-specific leave, separate from PSL and their regular PTO program; or if the employer has provided paid leave under a city- or county-mandated COVID-specific leave law.

Leaves Taken Between January 1 and February 18, 2022

If an employee took leave between January 1, 2022, and February 18, 2022, for a qualifying reason under the new SPSL, but was not paid for this leave in the amount required under this law, they have the right to request a retroactive payment equal to the amount required.

After the employee makes the oral or written request, the employer will have until the payday of the next full pay period to pay the retroactive SPSL.

An employee who used PSL or another type of paid time off for a qualifying reason between January 1 and February 18 will be entitled to request, orally or in writing, that those hours be converted to SPSL. Hours that were used from another bank (e.g., PSL or PTO) should be credited back to the employee.

Documentation from Employees

Employees are entitled to take Standard SPSL immediately upon oral or written request and may not be required to provide medical certification or proof of their need for leave.

Employers can require proof of an employee’s positive COVID-19 test to confirm their need for additional paid leave via Positive Test SPSL. While the law says an employer can also require proof of a family member’s positive test, the EEOC (Equal Employment Opportunity Commission) believes that this is prohibited by the federal Genetic Information Nondisclosure Act. We are hoping the state (or the EEOC) will provide guidance on this conflict.

Employers can require employees who take Positive Test SPSL to provide a negative test five or more days after their positive test before returning to the workplace. If this is required, the employer must pay for it.

Mandatory Notice

Employers must post a state-provided notice in a conspicuous location in the workplace. Employers whose workforces are remote, or partly remote, should ensure that those employees see the poster, either by sending it via email or posting it online. That notice should be made available next week on the Labor Commissioner’s webpage. We recommend checking this page frequently for the notice as well as promised FAQs.

Employers must also notify employees of how much SPSL they have used each pay period on their itemized wage statements or on a separate writing at the time wages are paid (even if that number is “0”). This requirement won’t be enforced until the next full pay period following February 19, so you have some time to work with your payroll department or provider to set this up.

Of note, last year’s version of SPSL required that employers show employees the remaining balance of their SPSL. Presumably, they have changed this rule because an employee’s balance is unknown—it will depend on whether they ever qualify for Positive Test SPSL, and for many employees, their balance will also depend on how many hours they have worked before taking leave.

2022 Healthplan Compliance Deadlines

Why America Has So Few Doctors

This is a great summary in the Atlantic: 

[The United States] has the longest, most expensive medical-education system in the developed world, and among the lowest number of physicians per capita. ...

Starting in the late 20th century, medical groups asserted that America had an oversupply of physicians. In response, medical schools restricted class sizes. From 1980 to 2005, the U.S. added 60 million people, but the number of medical-school matriculants basically flatlined. Seventeen years later, we are still digging out from under that moratorium. The U.S. is one of the only developed countries to force aspiring doctors to earn a four-year bachelor’s degree and then go to medical school for another four years. (Most European countries have one continuous six-year program.)

Free Cosmetic Surgery Offered In Massive Health Fraud Scheme

From ABC News:

The former executive director of a surgical center who helped her physician husband bilk insurance companies of $44 million for cosmetic procedures billed as “medically necessary” has pleaded guilty to health care fraud... For someone looking to trim some belly flab, downsize their nose or pump up their breasts, the deal was almost too good to turn down. Patients were promised free liposuction, nose jobs, breast augmentation and vaginal rejuvenation for free if they helped fudge the paperwork by signing 'testimonial' letters or declarations with false statements. Tummy tucks were listed on paperwork as hernia repair or abdominal reconstruction. Nose jobs were recorded as correcting a deviated septum. Breast jobs were supposedly to fix a 'tuberous breast deformity.' Linda Morrow admitted she coached employees to draft false documents, prosecutors said. Other documents were altered to cover up the true purpose of the surgery, according to court documents.

 

Only 14.3% of Hospitals Compliant with Price Transparency Rules After a Year | Meanwhile The Disclosures Made Reveal Price Disparities in Magnitudes of Ten

 This story really reminds me of this quote from James Madison:  

It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood: if they be repealed or revised before they are promulg[at]ed, or undergo such incessant changes, that no man who knows what the law is to-day, can guess what it will be to-morrow.

From Fierce Healthcare: 

Six months after finding only 5.6% of hospitals were in line with major price transparency requirements, an updated analysis from PatientRightsAdvocate.org found hospitals’ compliance has increased to just 14.3%—with the country’s largest health systems serving as the worst offenders.

According to the report, only 0.5% of hospitals owned by CommonSpirit Health, Ascension and HCA Healthcare met the federal requirements. For-profit HCA, the largest of the three, was found by the group to fall short across every one of its 188 hospitals. ...

According to the report, 85.7% of the 1,000 hospitals did not post a complete machine-readable file of standard charges, while 4.1% did not post any standard charges file whatsoever. Additionally, 58.6% did not clearly publish payer-specific negotiated charges while 26.2% did not publish any discounted cash prices. ...

'The lack of compliance by hospitals is about more than simply the failure to follow the legal requirements,' the group wrote. 'It is also about the failure of hospitals to provide critically needed information to consumers so they can make better health decisions. Empowered with comparative price and quality information in advance of care, consumers, including employers and unions, can improve health outcomes while lowering costs by taking advantage of the benefits of competitive market efficiencies.' 

Yes, some of this is, of course, about the myriad of byzantine requirements making it incredibly difficult for businesses to follow, but I suspect an even larger portion of this is the hospital industry's unwillingness to shine even more of a light on this, from the Los Angeles Daily News:  

Consider the wild price fluctuations at these [Los Angeles area] hospitals for just one service: a standard outpatient non-contrast brain MRI (billing CPT code 70551). The price of this treatment at Cedars-Sinai varies by approximately ten times depending on the payer, from $367 for Blue Cross Blue Shield Medicare plans to $4,043 for commercial Kaiser plans.

The price for consumers with Blue Cross HMO coverage is $2,162, nearly half Kaiser’s price. These prices do not include additional facility and physician fees that patients must pay.

Brain MRI prices also vary wildly across nearby hospitals. The price disclosures indicate patients covered by a Blue Cross HMO at Torrance Memorial pay just $127 — 17 times less than Blue Cross HMO patients pay for the same scan at Cedars-Sinai just 20 miles away.

In other words, prices can vary by more than ten times for the same service at the same hospital with different insurance coverage. And prices can vary by more than ten times for the same service at different hospitals with the same insurance. Consumers lose either way.

If you include Medicaid prices — Huntington Hospital lists the Medi-Cal Los Angeles plan price for this same brain MRI at just $39 — prices can vary by 100 times.

Pomona Valley lists a cash price for this procedure: just $450. This reasonable price begs the question: What’s the point of paying thousands of dollars in healthcare premiums every month if hospitals charge insured patients thousands of dollars more than those paying cash? The Cigna price at Pomona Valley for the same treatment: $6,500.

Standalone, cash-based MRI centers in Los Angeles offer brain MRIs for as low as $225 with no additional facility fees. This cash discount demonstrates how health industry bureaucracy and profiteering drive up prices.

 

State Laws Restricting COVID-19 Vaccine Mandates and Passports

Since COVID-19 vaccines first became available, several states have enacted laws that restrict or ban certain entities from mandating them or requiring proof that an individual has received one (also known as a “vaccine passport”) in order to be allowed entry or access to services.

Most of these bans and restrictions are generally pre-empted by the new federal EmergencyTemporary Standard (ETS)— which requires all employers with 100 or more employees to implement COVID-19 vaccination or testing policies— issued by the Occupational Safety and Health Administration (OSHA) on Nov. 5, 2021. However, a federal court has temporarily blocked that ETS from going into effect.

In addition, certain portions of these vaccine-related state laws may still apply even if the ETS does become effective. This is because the OSHA ETS does not preempt any “non-conflicting requirements of general applicability” that apply to “workers and nonworkers alike,” that “regulate workers simply as members of the general public,” and that are consistent with the federal standard. This Compliance Bulletin provides an overview of the state laws that currently restrict or prohibit COVID-19 vaccine mandates or passports. 

State	Vaccine Passport / Mandate Restrictions
Alabama	Effective May 24, 2021, Senate Bill 267 prohibits: Government entities from issuing vaccine passports or requiring an individual to receive a vaccine as a condition for government services, with exceptions; Educational institutions from requiring additional vaccines as a condition of attendance; and All businesses from refusing service to an individual based on the individual's vaccination status.
	Issued on Oct. 25, 2021, Executive Order 724 directs state agencies not to enforce the federal vaccine mandate and to cooperate with the state Attorney General's efforts to overturn it. It also prohibits state agencies from punishing businesses or individuals for noncompliance with federal vaccine requirements.
	Effective Nov. 5, 2021, Senate Bill 9 requires employers with vaccine mandates to allow certain exemptions.
Alaska	Effective April 26, 2021, Administrative Order 321 prohibits all state entities and the public from requiring an individual to show proof of vaccination in order to travel to or around the state.
Arizona	Issued April 19, 2021, Executive Order 2021-09 prohibits state and local governments from requiring proof of COVID-19 vaccination status to enter a business, building or area or to receive government service, permit or license.
	Effective July 1, 2021, Senate Bill 1824 prohibits state entities from establishing COVID-19 vaccine passports and requires all employers with vaccine mandates to provide reasonable accommodations if employees’ sincerely held religious beliefs prevent them from receiving the COVID-19 vaccine.
Arkansas	Effective April 28, 2021, House Bill 1547 prohibits state and local governments from: Requiring proof of vaccination as a condition of employment or to access education, goods, services, licensing or permitting; and Discriminating against or coercing individuals who refuse a COVID-19 vaccine by withholding opportunities for career advancement, wage increases or insurance discounts.
	Effective Oct. 13, 2021, House Bill 1977 requires employers that require COVID-19 vaccinations to establish a specific exemption process.
Florida	Effective July 1, 2021, Senate Bill 2006 prohibits all business entities from requiring patrons or customers to provide proof of a COVID-19 vaccine before being allowed entry to receive services.
	Effective Nov. 18, 2021, HB 1 prohibits vaccine mandates for certain employees and requires various exemptions from vaccination mandates.
Georgia	Issued May 26, 2021, Executive Order 05.25.21.01 prohibits state agencies and providers of state services or state property from implementing vaccine passport programs or otherwise requiring proof of COVID-19 vaccination as a condition of entering the premises of or conducting business.
Idaho	Issued April 7, 2021, Executive Order 2021-04 prohibits all governmental agencies from producing COVID-19 vaccine passports or requiring proof of vaccination to access state services.
Indiana	Effective April 29, 2021, House Bill 1405 prohibits the state and any local government from issuing or requiring vaccine passports.
Iowa	Effective May 20, 2021, House File 889 prohibits all businesses from requiring individuals to provide proof of having received a COVID-19 vaccination prior to entering the business premises.
	Effective Oct. 29, 2021, House File 902 requires all employers with COVID-19 vaccine mandates to waive the requirement for individuals who request exemptions for health or religious reasons. It also provides that employment terminations for refusing the COVID-19 vaccination will not disqualify an individual from receiving unemployment benefits nor will it affect an employer’s contribution or experience rates.
Kansas	Effective May 26, 2021, Senate Bill 159 prohibits state agencies from issuing or requiring an individual to use a COVID-19 vaccination passport within the state for any purpose.
	Effective Nov. 23, 2021, House Bill 2001 requires employers that impose COVID-19 vaccine requirements to provide medical and religious exemptions. It also establishes a complaint and investigation process and provides that employees who refuse the COVID-19 vaccine are not ineligible for unemployment benefits.
Michigan	Effective Sept. 28, 2021, Senate Bill 82 prohibits governmental entities and entities that receive governmental funding from producing, developing, issuing, or requiring a COVID-19 vaccine passport.
Missouri	Effective June 15, 2021, House Bill 271 prohibits a county, city, town or village that receives public funds from requiring documentation of an individual having received a COVID-19 vaccination as a condition of the individual accessing transportation systems or services or any other public accommodations.
Montana	Issued April 13, 2021, Executive Order 7-2021 prohibits all governmental entities and all private businesses from requiring vaccine passports to gain entry or receive services.
	Effective July 1, 2021,  House Bill 702 prohibits all employers in the state from discriminating against employees or applicants based on vaccination status or on whether the person has a vaccine passport.
New Hampshire	Effective May 27, 2021, House Bill 220 prohibits state and local governmental agencies from mandating that individuals receive a vaccination, including for COVID-19.
North Dakota	Effective May 20, 2021, House Bill 1465 prohibits all private businesses from requiring a patron or customer to provide vaccination status documentation, such as for that of COVID-19.
	Effective Nov. 12, 2021, House Bill 1511 prohibits businesses from requiring proof of COVID-19 vaccination status, post-transmission recovery status or antibody status. It also requires employers that require COVID-19 vaccinations to allow certain exemptions.
Oklahoma	Issued May 28, 2021, Executive Order 2021-16 prohibits state agencies from requiring vaccinations as a condition of entry to public facilities.
South Carolina	Issued May 11, 2021, Executive Order 2021-23 prohibits vaccine passports across the state and prevents schools and governments from creating mask mandates.
South Dakota	Issued April 21, 2021, Executive Order 2021-08 prohibits state and local agencies from developing vaccine passports or requiring proof of vaccination.
Tennessee	Effective May 26, 2021, Senate Bill 858 prohibits governmental entities from requiring proof of vaccination against COVID-19 as a condition of entering the premises or obtaining services.
	Effective Nov. 12, 2021, Senate Bill 9014 prohibits employers from requiring proof of vaccination from a person who objects to receiving a COVID-19 vaccine. It also provides for unemployment benefits if an employee’s separation is due to a refusal to receive a COVID-19 vaccination.
Texas	Effective June 16, 2021, Senate Bill 968 prohibits: Governmental entities from issuing vaccination passports containing an individual’s COVID-19 vaccination status; and All businesses from requiring proof of vaccination from patrons.
	Effective Oct. 11, 2021,  Executive Order GA-40 bans “all entities” from compelling any individual, including an employee or consumer, to receive a COVID-19 vaccine, if the individual objects based on personal conscience, religious belief or medical reasons. It also authorizes fines of up to $1,000 for violations.
Utah	Effective March 16, 2021, House Bill 308 prohibits state agencies and public universities from requiring proof of vaccination.
	Effective Nov. 16, 2021, Senate Bill 2004 requires employers with COVID-19 vaccine mandates to provide for certain exemptions. It also requires employers to pay for COVID-19 testing, prohibits adverse actions against an employee who claims relief and prohibits employers from maintaining a record or copy of proof of vaccination.
West Virginia	Effective Jan. 18, 2022, House Bill 335 requires all employers that require vaccination as a condition of employment to exempt employees and applicants who present certification of medical exemption signed by a medical professional or notarized certification of religious exemption. It also prohibits all employers from penalizing or discriminating against employees or applicants for exercising their rights to be exempt from vaccination mandates.
Wyoming	Effective Nov. 12, 2021, House Bill 1002 prohibits public entities from enforcing any mandate or standard of the federal government that requires an employer to mandate that an employee receive a COVID-19 vaccination.

 

Employee Benefit Plan Limits for 2022

Many employee benefits are subject to annual dollar limits that are periodically updated for inflation by the IRS. The following commonly offered employee benefits are subject to these limits:

• High deductible health plans (HDHPs) and health savings accounts (HSAs);
• Health flexible spending accounts (FSAs);
• 401(k) plans; and
• Transportation fringe benefit plans.

The IRS typically announces the dollar limits that will apply for the next calendar year well before the beginning of that year. This gives employers time to update their plan designs and make sure their plan administration will be consistent with the new limits.

This is a chart of the inflation-adjusted limits for 2022. Most of the limits will increase, although some limits remain the same for 2022. 

Links and Resources

• Revenue Procedure 2021-25: 2022 limits for HSAs and HDHPs
• IRS Notice 2021-61: 2022 limits for retirement plans
• Revenue Procedure 2021-45: 2022 limits for health FSAs, adoption assistance, and transportation fringe benefits

Limit	2021	2022	Change
HSA Contribution Limit
Self-only	$3,600	$3,650	Up $50
Family	$7,200	$7,300	Up $100
Catch-up contributions	$1,000	$1,000	No change
HDHP Minimum Deductible
Self-only	$1,400	$1,400	No change
Family	$2,800	$2,800	No change
HDHP Out-of-Pocket Maximum
Self-only	$7,000	$7,050	Up $50
Family	$14,000	$14,100	Up $100
Health FSA
Limit on employees’ pre-tax contributions	$2,750	$2,850	Up $100
Carryover limit	$550	$570	Up $20
Dependent Care FSA*
Tax exclusion	$10,500 ($5,250 if married and filing taxes separately)	$5,000 ($2,500 if married and filing taxes separately)	Return to traditional rules
Transportation Fringe Benefits (Monthly Limits)
Transit pass and vanpooling (combined)	$270	$280	Up $10
Parking	$270	$280	Up $10
401(k) Contributions
Employee elective deferrals	$19,500	$20,500	Up $1,000
Catch-up contributions	$6,500	$6,500	No change
Adoption Assistance Benefits
Tax exclusion	$14,440	$14,890	Up $450

* This limit is not generally subject to annual adjustment for inflation. However, for 2021, the American Rescue Plan Act (ARPA) increased the limit to $10,500 (or $5,250 for married individuals filing separately) due to the COVID-19 pandemic.