Repealing the Affordable Care Act (ACA), long a Republican priority, is unsurprisingly at the center of President-elect Trump’s healthcare agenda. But don’t throw out those 1095-C’s just yet.
“Even if the ACA is ultimately repealed in full or in part, it is unlikely to happen on ‘day one,’” attorneys from Proskauer Rose LLP observed in a blog post. “Therefore, at least for the time being, employers and plan sponsors should continue operating their health plans in compliance with the ACA.”
Consultants at Mercer also urged patience and caution. “Many employers welcome the promise of repeal of certain ACA requirements, especially the excise tax, the employer mandate, and reporting,” according to a posting from Tracy Watts and Geoff Manville. “But be prepared: it could take time—a year or two—for the transitions to take place,” perhaps as part of a plan for covering the 25 million currently with exchange and Medicaid coverage under the ACA.
Trump’s preliminary plans for replacing the ACA will include a greater role for health savings accounts and the revival of state high-risk pools. The incoming administration, according to a policy statement, also “will work with Congress to enable people to purchase insurance across state lines.”
Repeal of the ACA’s employer reporting mandates should be high on the list, argued the ERISA Industry Committee (ERIC), a plan sponsor coalition. “Neither employers nor employees are served well by millions of dollars being wasted just to prove that we offer health insurance,” stated James Gelfand, ERIC senior vice president of health policy. “There are bipartisan bills that would help in this space, and Congress should stop arguing and pass them immediately.”
Beyond the ACA, however, ERIC warned against interfering with employer-based health coverage. “Any changes to the healthcare system need to preserve, promote, and improve the employer-sponsored system—and if changes are proposed that would harm this system, ERIC will fight them with everything we’ve got.” An ACA replacement plan aired earlier this year by congressional Republicans drew fire from ERIC and other groups for proposing to cap the tax exclusion for employer-sponsored coverage.
Pending and proposed regulations often are put on hold by incoming presidents, and Trump also could order agencies to stop enforcing existing rules, Proskauer noted. However, repealing requirements like the employer mandate and related reporting would take statutory action, although such provisions could be enacted through the budget reconciliation process (without risking a filibuster) to the extent they are revenue-related.
“Ultimately, it is far too early to know exactly what President-elect Trump and the Republican-controlled Congress will do with respect to the repeal of the ACA and the enactment of new healthcare reform or what the impact of any of those changes will be,” concluded Proskauer attorneys Robert Projansky, Steven Weinstein and Damian Myers—a contributing editor of Mandated Health Benefits—The COBRA Guide.