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The Future of the Affordable Care Act

By: Cal Kellogg, executive vice president of external operations and chief strategy officer, Arkansas Blue Cross

With the results of the presidential election, the elections in the House and Senate completed and the inauguration just days away, many are asking what are the implications for the Affordable Care Act (ACA) and how health insurance might change under a Trump administration.

While members of the House and Senate are still talking about repealing the entire ACA, a total repeal without any replacement may be challenging. However, repealing parts of it is very much possible. Even now, it is too soon to fully know what will happen. However, there are several key things to keep in mind.

First, for the small group and individual markets (including Medicare Advantage) open enrollment is either over or nearing completion. Many people have purchased 2017 products and their coverage is already effective. It is highly unlikely that any repeal activities would have a direct impact on 2017 products as the federal government has already committed to those products and marketplace rules.

Second, repeal and replace activities will have to move through a budget reconciliation process that may take several months, so it will be a while before anyone knows what the 2018 plan year will look like and what parts of the ACA will be repealed, what will stay in place and what new twists might be added.

Looking at 2018 and beyond, there will likely be many changes to the ACA and some things will be retained. Some of the likely changes will be modifications to the essential health benefits, individual and employer mandates, many of the taxes and fees on ACA products, definition of full-time employees and some preventive services. Things that likely will remain are no pre-existing conditions, guaranteed issue and coverage for children to age 26. Current thinking suggests the ACA will be repealed but there will be a transition period of two to four years, and in the interim, individuals and groups will be able to keep what they have.

As with the first wave of healthcare reform brought on by the ACA, this second wave of reform will not happen suddenly, but will very likely be handled in a transition period for all of our key markets. Just as we advised people nearly seven years ago when the ACA was first passed, don’t make any changes until we know what the new rules will be. As soon as we know more about the actual changes, we will work with you to help you understand the new rules and how they will affect everyone.