In Focus: The Trump Administration and the ACA

ACA Likely to Change
Substantially but Full Repeal Unlikely

employer mandate to provide coverage—and all the tracking and reporting
requirements that accompany it—could go away, even without a full repeal
of the Affordable Care Act (ACA). The Cadillac tax on high-value plans is also
on the block. A look at the prospects for major reform of health care reform.


Outright Repeal of the
Affordable Care Act Would Be Difficult

Donald Trump vowed during his campaign to dismantle the Affordable Care Act
(ACA). That will be a challenge for a Trump presidency because advocates of
“repeal and replace” would need 60 votes in the Senate to overcome a
Democratic filibuster in the Senate—and the election didn’t put that many
Republican senators in place. But even if Trump can’t repeal the ACA in its
entirety, there is much he could do through rule-making and smaller legislative
changes to weaken the law and mold it more to his liking.

Some Provisions Could Be
Rolled Back Using ‘Reconciliation’

most Senate bills need 60 votes to overcome a filibuster, Senate rules allow
bills to pass with a simple majority if they only relate to spending, a process
known as reconciliation. Last winter, Republicans drafted a bill that would fit
the parameters of the reconciliation process. It would repeal the ACA’s tax
credits for low- and middle-income Americans to purchase insurance and would
end the ACA’s Medicaid expansion, essentially creating a two-year transition
period in which Republicans would consider ACA replacement plans.

Trump’s Ideas for Health
Care Reform

has promised that on the first day of his administration he would ask Congress
to immediately deliver a full repeal of the ACA, including the individual
mandate. Trump has called for modification of existing law that inhibits the
sale of health insurance across state lines, full deduction of health insurance
premium payments from individuals’ tax returns and price transparency from all
health care providers.

Cadillac Tax Will Be

ACA’s unpopular Cadillac tax—a 40 percent excise tax on high-value employer
plans—will be one of the first targets of the Trump administration. Trump may
also draw on a plan proposed by Republicans in the U.S. House that includes a
refundable tax credit to help Americans buy individual plans, and he wants to
eliminate the law’s individual mandate that requires Americans to buy health
insurance or face a penalty.
(Employee Benefits Advisor)

ACA Provisions that Are
Likely to Remain

has said he favors keeping many of the provisions in the ACA, including no
pre-existing condition exclusions, allowing children on parents’ plans through
age 26, no lifetime limitations on coverage, no rescissions, guaranteed
renewability and continuing coverage protections.

What an ACA Replacement
Bill Might Look like

Trump and House Speaker
Paul Ryan have given only broad outlines of what an ACA replacement bill would
look like. They’re relatively similar plans: Individuals would get tax credits
to help them buy insurance, tax-favored health savings accounts would be encouraged,
insurers would be allowed to sell policies across state lines. Neither has
filled in details, however.

Article source:

Changes may be heading
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