What will a Biden presidency mean for company and HR leaders? Likely a greater focus on workplace safety and relief in a COVID-19 world, stemming rising healthcare costs and improving care, industry experts say.

In the near-term, it’s all eyes on healthcare as the pandemic rages on. Employers will look to the presumed Biden administration for help to improve the health and wellbeing of workers, observers say.

Lorrie Lykins of i4cp

“The pandemic has glaringly highlighted all of the health policies and the health challenges that existed anyway. I think health, COVID—all of that stuff will be top of mind,” says Lorrie Lykins, vice president of research for the Institute for Corporate Productivity.

See all of HRE’s COVID-19 coverage here.

“Certainly employers have done a tremendous amount during this time of pandemic to provide additional support and resourcing via expanded telehealth and virtual solutions, mental health and behavioral health supports, caregiving and childcare resources, and expanded leave programs, to name a few,” says Ellen Kelsay, president and CEO of the Business Group on Health. “These will be continued areas of focus throughout the upcoming weeks, months and years ahead. Employers will look to the administration for regulatory support in these areas—in addition to vaccine distribution, payment and coverage issues.”

President-elect Joe Biden has said his main priority is the COVID-19 pandemic. He already has set up a task force on the disease, and he has called out the importance of masks and other health and safety guidelines. That stance may mean a continuation in remote work policies and more aggressive workplace safety measures—although most employers are already doing that and the majority are not forcing their workers back into the office anytime soon, Lykins says.

“I think there’s definitely going to be a national strategy, and it will be interesting to see how that evolves,” she says. “I think it’s wise that he’s repeating the message that this is about health, managing infections and having a healthcare strategy.” Still, she says a lot of employees have communicated reluctance to return to the workplace until there’s a vaccine and “employers are listening to that and honoring that and working their strategies around that.”

Mike Thompson

Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, agrees that COVID-19 response—including workplace safety and vaccine distribution—will be top of mind for the administration and for employers early in Biden’s presidency.

“A Biden presidency will have to shift to consider the impact of the emergence of one or more vaccines. The administration will need to rebuild trust in vaccinations, and employers can be a great ally in doing so,” Thompson says. “In the transition to broad vaccination, Biden will also need to provide leadership to sustain safety measures such as masking and social distancing throughout next year. While these safety measures will continue to wear on workers, it may ultimately create less disruption to our workforce and economy.”

Related: What HR needs to know now about COVID-19 vaccine policy

Biden will also likely resurrect healthcare reform—most specifically around a public option, surprise billing and drug prices, Thompson says. But that will require support across the political spectrum. The matter takes on more urgency as the Supreme Court will hear a case on the validity of the ACA starting this week.

“To gain support of the employer community, reforms must tackle both healthcare costs and access to care. If the ACA is overturned by the Supreme Court, non-action will be unacceptable.”

The most important healthcare issue for the president-elect to address is the continuous rise in healthcare costs, observers say. A Mercer poll of employers found that the vast majority say the top healthcare reform priority for the new administration is reducing drug prices (cited by 83%), followed by promoting greater healthcare transparency (67%), supporting cost-effective expansion of telemedicine (42%), addressing Medicare solvency and promoting provider payment reform and value-based care  (42%).

Annual family premiums for employer-sponsored health insurance surpassed $21,000 this year, according to Kaiser Family Foundation analysis, although that figure primarily reflects pre-pandemic levels.

“When we look back at 2020, healthcare costs will be down a bit because of care that was missed due to the pandemic. There are fears that employer spend on healthcare next year and beyond will again outpace inflation,” says Jeff Levin-Scherz, co-leader of the health management practice at consulting firm Willis Towers Watson. “The Trump administration has suggested prices pegged to international indexes in pharmacy, although it has not promulgated a proposal. The Biden campaign has suggested an expansion of Medicare, which has lower prices. A Biden administration might also be more vigorous in enforcing antitrust laws, given the increasing pace of provider consolidation, which has been well-documented to raise unit costs.”

Biden proposes lowering the eligibility age for Medicare to 60—from 65 currently—which may cause workers to retire earlier since many employees work until 65 so they can stay on their employer-sponsored insurance until they are eligible for Medicare. “I think we’ll see boomers retire earlier,” Lykins says. Additionally, that might leave room for more opportunity for Gen X to move into senior roles that “they haven’t been able to reach because there have been five generations in the workplace.

“That may really create a generational shift in the workplace,” she says. “There’s a lot that remains to be seen.”