21 Nov The Affordable Care Act (ACA) and a Trump Presidency…
The Affordable Care Act (ACA) and a Trump presidency
It’s been just over a week since the presidential election and I think we’re already getting a sense of how the new Administration is going to operate. Ideological rhetoric seems to be giving way to more pragmatic discussions about the future of healthcare and the ACA. But until we see who Trump appoints to leadership within his Administration, there’s still a lot we don’t know. And on Capitol Hill, Paul Ryan appears to be returning to the House Speaker position, and he has some proposals regarding the ACA too.
When the ACA (“Obamacare”) was passed we knew it would be a long journey with profound effects on healthcare and employee benefits. The election of Donald Trump will bring about even more change. The question that NO ONE can answer is exactly WHAT will change. It has taken more than 5 years to work through the implementation of the ACA; repeal/replace may take just as long. In the short term (in addition to lots of bickering, arguing, posturing and pontificating), we know:
- Reporting requirements for plan year 2016 (1095’s, etc.) will remain due in early 2017
- Despite the noise, nothing substantive will happen to impact the 2017 plan year
- Covered California and other state programs will remain in full force, for now
Less certain but possible for 2018 and beyond are:
- Pieces of the ACA will remain, such as no Pre-Ex limits and Dependents to age 26 coverage
- The individual mandate (and perhaps aspects of the employer mandate) will go away, taking with it many of the current reporting requirements
- Federal Exchanges have a very uncertain future as do premium subsidies
- Limited benefit or ‘Skinny Plans’ will be back
- The Cadillac tax will be gone, but the deductibility of premiums may also change
- The scope of HSAs will likely increase significantly
Many of these initiatives will significantly change the risk exposure of insurance carriers, most of whom are taking a ‘wait and see’ attitude. Health insurance is regulated at the state level so some of the changes might not be felt here is California given our politics, but no one really knows.
About GSI Benefits: We strive to be apolitical, our focus is on always providing you with the analysis to understand and implement what works for your organization. So much of the ACA did not pertain, or only marginally applied to employers here in California. While it can be interesting to wonk out (and panic) about the macro implications of Federal level policies, our partners are interested in what change means to their specific corporate situation. That’s our focus, and our value.