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Trump Administration hints about healthcare changes

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

During President Donald Trump’s joint address to Congress on Tuesday, February 28, we got a glimpse at what may happen to the Affordable Care Act (ACA), and the administration’s approach to transitioning to a new set of health insurance rules. Clearly, the ACA will in large part be repealed, but there will be significant components that will be replaced and some new twists will be added.

Lately, the Trump administration has begun to issue new rules and to clarify its stance on enforcement of certain aspects of the ACA going forward. Notably, the IRS said it will not require tax filers to prove they had coverage for the 2016 tax year and will not collect the penalty on people who did not have coverage, effectively ending the individual mandate. It also is highly likely the administration will eliminate the employer mandate to offer coverage to all full-time employees and the additional reporting will not be required in future tax years. Also, the administration is signaling it will stabilize the individual ACA marketplaces for 2018 and allow people to keep the coverage they have if they like it. For example, group and individual policies sold between March 23, 2010, and December 31, 2013, can be renewed for one more year while the replacement policies are developed. Individuals and groups will not be forced to purchase ACA-compliant policies beginning January 1, 2018, as was previously required under the transition rules. The administration also is talking to Congress about ways to eliminate taxes and fees imposed by the ACA in order to take some of the pressure off of price increases for the 2018 individual and small group markets.

In the meantime, the House and Senate are both working on repeal and replacement legislation. While there is some disagreement on specifics and timeline, there is agreement on several fundamental issues. First, trying to preserve the coverage gained by approximately 20 million people is at the forefront of the discussion. Second, identifying and eliminating aspects of the ACA that artificially drove up costs for individuals is the current focus of repeal efforts. Third, giving regulatory power back to states for the individual and small group markets is an underlying principle for replacement packages. And lastly, certain aspects of the ACA will remain in place, things like guaranteed issue of coverage, covering children to age 26 and some form of federal assistance for those not offered employer or government-sponsored coverage.

The most important thing to remember is all of the repeal and replacement items are fluid and not cast in stone. This simply gives you an idea of the direction we are headed over the next several months. For now, most aspects of the ACA remain in place and — with only a few exceptions — the rules are still in effect. So for now stay focused on working within the current system, but be prepared for the changes that will come over the course of the next several months.

We will try to keep you updated when those changes happen so you can plan for the future.