Potential Changes to the ACA and Healthcare Under President-elect Trump

Throughout his presidential campaign, Trump ran on a platform of repealing and replacing the ACA. In addition, since its enactment, Republicans in both the Senate and the House of Representatives have virtually all opposed the ACA, calling for its repeal. According to benefits industry experts, Trump’s nomination of U.S. Representative Tom Price—a retired surgeon, staunch critic of and one of the main composers of legislation drafted to repeal and replace the ACA—as the secretary of the Department of Health and Human Services (HHS), demonstrates his seriousness about repealing and replacing the current health care reform law.

 

Republicans in Congress plan to move quickly in January 2017 to repeal the ACA and delay the effective date of the repeal so they have a few years to phase it out. Their “repeal and delay” strategy, which is being primarily coordinated by Speaker of the House Paul Ryan and Vice President-elect Mike Pence, is designed to streamline the impending changes. Plan details, including changes, have yet to be released.

Republicans in the past have suggested the following:
• Partially repealing key provisions (such as the individual and employer mandates), while retaining some less controversial provisions
• Changing the Medicare and Medicaid programs
• Implementing new policies intended to expand coverage and lower health care costs

Over the course of his campaign, Trump has proposed making the following changes:
• Getting rid of the Exchanges
• Creating tax-free health savings accounts (HSAs) for people with high deductible health plans (HDHPs)
• Establishing state-based high-risk pools for people with certain medical conditions that would otherwise face difficulty obtaining coverage on their own
• Enabling insurance companies to sell insurance across state lines
• Eliminating both the Cadillac tax and the individual mandate

Additionally, there has been talk of potential changes to what types of services will be included under the preventive care the ACA currently requires insurers to provide at no cost to insured individuals. This could impact a variety of women’s health issues, as women have had access to free birth control methods through their insurance plans under the preventive health benefits provision.

It is unlikely that a complete repeal or any substantial changes to the ACA will occur until plans have been carefully drafted. Moreover, it is likely that a few of the current stipulations of the ACA will remain untouched, including the following:
• Rule requiring group health plans and health insurance issuers to offer group or individual coverage that provides dependent coverage to children on their parents’ plans until the adult child reaches age 26
• Rule prohibiting insurance companies from refusing to cover individuals with pre-existing conditions or charging more because of an individual’s pre-existing condition.

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We will be sure to keep you updated as changes are considered and implemented in the year to come. For now it’s business as usual, please keep up with the current ACA compliance and reporting until otherwise noted and feel free to call us with any questions.