Right before the House vote on the new health care legislation, the Senate approved a $1.1 trillion spending bill that will finance the government until September and prevent a government shutdown. The approval of the spending bill allowed the House to safely pass the American Health Care Act (AHCA).
While House Speaker Paul Ryan is hopeful that the Senate can pass a bill meant to replace the Affordable Care Act (ACA) in a couple months, this is highly unlikely. The Senate, which moves more slowly than the House, will now begin work on creating a health care plan that will be acceptable by all the factions of the Republican party. This could mean that the Senate will need to write a new bill all together.
Because the members of the GOP are divided on the issue of a new health care bill it may prove to be a challenging task to pass it. Furthermore, the Senate needs a 51-vote majority to pass the bill, which allows them only two defections. The Senate is expected to take until August to push a bill through with the needed support. When the Senate produces a new or updated bill it will return to the House for a vote.
Until the Senate and House agree on a new health care bill, the ACA remains in place. Thus, those selling and buying health insurance will be adhering to the rules and regulations already in place.
On May 4, Congress approved legislation to repeal and replace major parts of the Affordable Care Act (ACA). The latest version of the American Health Care Act (AHCA) rolls back the expansion of Medicaid and allows states to opt out of covering patients with pre-existing conditions. The bill now faces uncertainty in the Senate.
The proposed AHCA would end Medicaid’s status as an open-ended entitlement. The bill will also repeal taxes on the super rich, insurers and drug companies. Furthermore, under the new bill, states could adjust coverage for essential medical services such as maternity and emergency care. The latest AHCA seems to be a patchwork of provisions.
The bill will most likely be amended by the various Republican factions within the Senate. In addition, the Senate Republicans have been working on their own version of the health care bill, which will consider the ideas already in the House bill. Once the Senate passes its new or updated version of the AHCA, that bill will return to the House for another vote.
However, the biggest unanswered question with any replacement of the ACA is that no one can calculate how many people would be covered under a new health care bill. By May 22 the Congressional Budget Office (CBO) will release its report on the cost and potential coverage of the new AHCA. The analysis of this bill will be complicated by the fact that it leaves a lot to the states. It will be up to the Senate Republicans to consider the implications of the upcoming CBO report.
Until Congress passes the proposed American Health Care Act, the current rules and regulation regarding the ACA remain in place. This means that the following aspects of the ACA must still be complied with for the duration.
Some of the rules and regulations that must still be followed include, but are not limited to:
- Anti-discrimination rules related to transgender benefit protections and their enforcement
- Individual and employer mandates and fines/taxes for non-compliance
- Market reform mandates and IRS tax enforcement from large employers whose self-insured group plans do not satisfy market reform rules
- Reporting obligations/IRS tax enforcement of dues from large companies failing to accurately and in a timely manner report coverage offered to workers/dependents
The rising opposition to the proposed American Health Care Act, is likely going to cause a delay in the ability for the Act to pass through the House and Senate. Many voices of opposition are voicing their concerns that rushing through this healthcare act and not allowing it to be properly vetted will have the potential to adversely affect many Americans.
The next few months or years are likely to be confusing and frustrating. Insurance agents, brokers and carriers are going to be doing their best to stay on top of the latest changes.
Late January, President Trump signed a healthcare executive order that could impact employers, even if it did not specifically mention them.
The executive order instructed federal agencies to, “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement that would impose a fiscal burden,” on states, health care providers or individuals. The order can undo individual mandates to purchase insurance and other mandates placed on employers, like providing full-time employees with coverage.
The employer mandates may be regarded as a fiscal burden, according to the wording of the executive order. The employer mandate may become questionable if there is no tax on individuals who do not have minimum essential health insurance.
Nonetheless, it is advisable for all employers to continue complying with the established rules by the ACA until the GOP proposed American Health Care Act (or another act) is implemented.
The transition from the ACA to the proposed American Healthcare Act may be painful and prolonged. Stay on top of what is happening in the industry and understand your existing health coverage to be able to evaluate what may replace it.