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Each year, the National Association of Benefits and Insurance Professionals (NABIP) gathers in Washington, D.C., for its Capitol Conference, bringing together hundreds of agents, benefits specialists, and industry leaders to engage directly with federal policymakers.

The event serves as a coordinated advocacy effort, where NABIP members from across the country deliver a unified message to Congress on the most pressing issues impacting the health insurance landscape. This year’s discussions focused on federal priorities tied to cost transparency, coverage stability, Medicare access, and related policy considerations.

Price Transparency and Cost Reform

NABIP members and industry professionals urged Congress to cosponsor the Patients Deserve Price Tags Act (S. 2355 /H.R. 5582).

While federal price transparency requirements already exist, enforcement has been limited, and in many cases, the data produced is not usable for employers or consumers. Disclosures are often incomplete, inconsistent, or formatted in ways that limit their utility.

This legislation seeks to address those challenges by requiring standardized and enforceable disclosures across providers, including negotiated (in-network) rates, cash prices, bundled service pricing, and prescription drug costs. It would also ensure employer plan sponsors have access to complete claims and pricing data without contractual barriers that otherwise restrict transparency.

NABIP also engaged in a broader policy discussion around site-neutral payment reform, encouraging Congress to consider codifying policies that would require the same cost for the same service regardless of where it is delivered. Today, services performed in hospital outpatient settings are frequently reimbursed at significantly higher rates than identical services in physician offices, even when performed by the same provider. This dynamic is largely driven by provider consolidation and facility-based billing practices rather than differences in quality or complexity.

Preserving Coverage and Expanding Choice

To address ongoing affordability challenges in the individual market, NABIP called on Congress to stabilize the ACA Exchange Marketplaces, particularly following the rollback of enhanced Premium Tax Credits (PTCs) introduced during the pandemic and extended for several years.

As those enhanced subsidies phased out in 2026, many Individual and Family Plan (IFP) consumers have experienced higher premiums, reduced affordability, and, in some cases, coverage loss or a shift to less comprehensive plans. Agents continue to see these impacts firsthand, making them a critical voice in shaping practical stabilization strategies.

Congress still has the ability to revisit and retroactively extend enhanced PTCs for 2026, since eligibility is ultimately reconciled at year-end through the tax filing process.

NABIP also reinforced the importance of preserving the tax exclusion for employer-sponsored health coverage, a long-standing policy that allows employer contributions toward premiums to be provided without being treated as taxable income for employees, while also remaining a deductible business expense for employers. This tax treatment remains a foundational component of the employee benefits system, and changes to it could significantly increase costs for both employers and employees while destabilizing coverage for millions of Americans. While not tied to a specific bill, this discussion highlights the importance of maintaining current tax treatment and educating policymakers on how employer-sponsored coverage functions in practice.

NABIP also requested congressional support for several pieces of legislation:

• H.R. 5463 – The CHOICE Arrangement Act: NABIP urged lawmakers to cosponsor this bill, which would codify Individual Coverage Health Reimbursement Arrangements (ICHRAs) into federal law. ICHRAs are currently permitted through regulatory interpretation, meaning they can be modified, reinterpreted, or reversed by future administrations. Codification would provide long-term stability as employers increasingly adopt these arrangements. 
• H.R. 2082 – The WISH Act: NABIP also encouraged co-sponsorship of this bill, which proposes the creation of a federal long-term care benefit under Social Security. Long-term care remains one of the most significant and least predictable financial risks facing retirees, often requiring individuals to spend down assets before qualifying for Medicaid. This legislation would provide a more structured and sustainable approach to addressing those costs. 

Medicare and Consumer Access to Guidance

NABIP members also spent considerable time discussing Medicare policy, with a strong focus on preserving beneficiary access to licensed agents and brokers.

NABIP is urging Congress to establish guardrails around Medicare agent compensation, particularly to prevent reductions or eliminations of commissions after October 1 (the start of the Medicare Annual Enrollment Period) or mid-plan-year changes that disrupt consumer access to agents during a critical decision-making window. Recent market dynamics, including carrier adjustments to compensation structures and distribution strategies, have introduced instability into the Medicare landscape. These shifts can limit access to independent guidance and plan options at a time when beneficiaries rely heavily on professional support.

While these conversations are currently focused on the Medicare market, there is broader concern about similar practices emerging in other segments of the industry. Raising awareness among federal policymakers is key to preventing further disruption.

NABIP also requested support for the following legislation in the Medicare space:

• H.R. 2744 – The Medicare Enrollment Protection Act: NABIP urged Congress to cosponsor this bill, which would treat COBRA as creditable coverage, allowing individuals enrolled in COBRA to delay enrollment in Medicare Part B without penalty and transition to Part B coverage without incurring late enrollment penalties. Under current rules, COBRA is not treated the same as active employer coverage for Medicare timing purposes, creating confusion and unintended financial consequences.
• S. 2625 – The Independent BROKERS TIME Act: NABIP also called for co-sponsorship of this legislation, which directs the Department of Health and Human Services (HHS) to re-evaluate the current regulatory framework governing Medicare agents and brokers. Recent rules have applied broad, one-size-fits-all requirements that do not distinguish between licensed professionals and large marketing organizations, potentially limiting access to trusted, relationship-based guidance.

Looking Ahead

The policy priorities discussed at this year’s Capitol Conference reflect a broader focus on improving transparency, preserving coverage structures, and maintaining access to professional guidance across all segments of the market.

While these discussions take place in Washington, DC, their impact is far-reaching, influencing affordability, plan design, regulatory requirements, and the overall experience of consumers navigating the health care system.

NABIP and its members will continue engaging with federal policymakers to advance these priorities while supporting practical, sustainable solutions for the industry and the individuals it serves.