Affordable Care Act: What the Uncertainty Means for You

Aug 03, 2017
| Anissa Kurtz
Affordable Care Act Uncertainty

When the Affordable Care Act (ACA) was signed into law on March 23, 2010, it represented the U.S. health care system’s largest overhaul and expansion of coverage since 1965. The main goal of the Act was to ensure more Americans had access not only to health insurance, but health insurance they could afford. What we’ve learned is that health care reform was, in large part, health insurance reform, the impact of which landed heavily on employers both large and small. In addition to the burden of understanding the law’s complexities and meeting the compliance requirements, the ACA presented employers, employees and insurance brokers with a great deal of uncertainty.

In the years since many of the provisions took effect, companies and brokers have become much more comfortable dealing with the complexities of ACA laws and regulations. But as is usually the case, once comfort levels rise, something comes along that causes disruption.

In this case it was the 2016 presidential election. With the Trump administration now in office, one of their biggest efforts is to undo several key provisions of the Affordable Care Act and replace them with new legislation. This has once again brought a great deal of uncertainty around health insurance and the future of health care reform.

Let’s take a look at some of the latest news and updates that surround the Affordable Care Act, and what they may mean for you:

Uncertainty Could Cause Large Insurance Premium Increases 

Insurers aren’t sure how the Trump administration will handle ACA moving forward. This uncertainty could lead to double-digit premium increases for 2018. Two areas are particularly worrisome for insurers: if individuals will still be required to purchase insurance and whether subsidies for low-income enrollees will be stopped. 

Halting subsidies that help insurers offset health care costs for low-income Americans is an idea that the administration has mentioned in the past. Ending this cost-sharing reduction (CSR) program could cause large-scale problems for the Affordable Care Act, even without the use of legislation. Doing so could cause companies to raise premiums further or stop offering coverage all together. This is certainly something to stay tuned to as the deadline for the next CSR payment approaches.

To Comply or Not to Comply

One of President Trump’s first acts in office was an executive order aimed at “minimizing the economic burden of the Patient Protection and Affordable Care Act (PPACA).” This executive order empowered the heads of several federal agencies to “waive, defer, grant exemptions from or delay the implementation of any provision of the act that would impose a fiscal burden.” This order doesn’t change the law in any way but has left business owners and insurance carriers wondering not only if they are required to comply but if they should.

Last week, efforts to pass new health care legislation in the Senate stalled. Nicknamed the “skinny repeal bill,” it sought to overturn several key ACA requirements, but failed to get the majority vote needed to advance it. What does this mean?

Until further developments occur, the Affordable Care Act and its requirements are still in effect. Most importantly, this includes all penalties for noncompliance. Until any new laws are passed, companies and brokers should operate under the rules and guidelines of the ACA.

All Existing ACA Coverage Requirements Are Still in Effect

Despite its faults, the ACA resulted in a number of positive changes to insurance plan designs and coverage such as the removal of pre-existing condition limitations/exclusions, the elimination of lifetime maximums and 100 percent reimbursement for preventive care. Many Americans are concerned that replacing the ACA will mean the removal of some of these provisions and the loss of coverage enhancements they have come to appreciate and count on. 

Stay as Up-To-Date as Possible

These next weeks and months could see large-scale impacts to health care in the United States. Despite last week’s vote, both parties have said that next steps may include bipartisan efforts to fix ACA and help stabilize the health care market. However, no specific plans or dates have been mentioned. 

Following the latest news and updates should help you stay as informed as possible, and at least prepare you for any potential health care changes that may or may not be coming. Despite the uncertainty, there are still ways to keep your business ready and compliant with current ACA regulations. Learn more about that here. Staying on top of the news can be a game-changer for your business.

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