Following their victory in November’s US elections, the Republican Party has vowed to dismantle the Affordable Care Act, the health insurance reform package considered the centerpiece of outgoing President Barack Obama’s legislative agenda, and one that has had major consequences for employers. President-elect Donald Trump campaigned on repealing the ACA—a longstanding Republican priority—but later suggested he might try to retain elements of the law that have proven popular with the public. On Wednesday, the New York Times reported, Republican Congressional leaders and vice president-elect Mike Pence stressed that they were serious about their commitment to doing away with the law, popularly known as Obamacare.
The Times lays out the Republican strategy for doing so on an accelerated timetable, beginning with procedural maneuvers to enable them to repeal the ACA with a simple majority in the Senate, avoiding a Democratic filibuster, before moving on to repealing individual provisions of the law while Trump uses his executive powers to reshape health care policy. Not everyone is confident that the GOP can pull it off, however. At CFO, David McCann expresses doubt that they will move as quickly as they say they will to repeal the ACA:
In any event, getting started on the repeal is unlikely to be the new Congress’ first order of business, given the controversy over several of Trump’s nominations for Cabinet posts. However, Republicans in Congress are expected to issue a budget reconciliation bill within weeks that will include an effective repeal of Obamacare that would not take effect for two or three years. …
Still, it’s not hard to find informed observers of the health-care industry that are skeptical that such a “repeal-and-delay” scheme will come to fruition. “I think it’s a purely political tactic and not meaningful,” says Julie Stone, a national health-care practice leader for Willis Towers Watson.
In fact, Stone says, “the provisions of the ACA that most impact employers are likely not going to be dramatically changed.” That’s a reference to (1) the mandate that employers provide health benefits meeting minimum standards or pay a penalty, (2) reporting requirements under the law, and possibly (3) the so-called “Cadillac tax” — the excise tax on employer health plans over a certain value.
Other observers tell Stephen Miller at SHRM that while a rapid repeal looks likely, creating a new policy framework to replace Obamacare is going to take a lot longer than the GOP is letting on:
Opponents “cannot stand in the way of a repeal bill if the president goes out and says he wants it. They may be able to do some things to modify the transitional uncertainty, but it is happening,” said Randy Hardock, a partner at law firm Davis & Harman in Washington, D.C.
The taxes that the ACA imposed on employers will “go away,” he predicted. “But once they pass repeal, they won’t work on replace for two or three years, because the Democrats need to be brought to the table, and they’ll never cut a deal until the end” of the Congressional session.
“I do think they’ll pass a repeal bill, but I would speculate that they’ll try to do pieces of replace along with repeal,” said Katy Spangler, senior vice president, health policy, for the American Benefits Council, a trade association based in Washington, D.C.