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Health care was looking like more of the same—then the coronavirus came along. Self-funded plans and the entire industry now faces accelerated systemic change, thanks to the biggest health crisis in recent history.

Early in 2020, health care reform discussion mainly centered around a Medicare-for-All plan versus maintaining the status quo. That hot-button issue, however, largely quieted with Vermont Senator Bernie Sanders exiting the Democratic Party’s primary race and former Vice President Joe Biden emerging as the candidate.

Biden, who helped usher the passage of the Patient Protection and Affordable Care Act (ACA) as vice president in 2010, indicated he was unlikely to make massive changes to the law if elected. Meanwhile, President Trump seemed content to just chip away at elements of the ACA, such as eliminating the tax penalty for the individual mandate to carry coverage and has yet to present any major reform plan.

Nearly all reform issues quickly seemed irrelevant by the time Sanders announced his departure on April 8 and it had nothing to do with the election. COVID-19 rapidly became the only health care topic in the U.S. and across the world that mattered. The virus has created enormous uncertainty around all clinical and economic elements of the health care industry, including self-funded plans.

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