Independent Health is closely following efforts by President Donald Trump and the Republican-controlled Congress to repeal and replace the Affordable Care Act (ACA) and will keep our customers up-to-date on developments. We provide this latest overview in our occasional series of ACA updates.

January 11, 2017 Update:
The Repeal of the Affordable Care Act: what does it mean?

american flag with stethoscope in foreground

President Donald Trump and the Republican-controlled Congress have made the repeal and replacement of Affordable Care Act one of their top legislative priorities.

At the same time, Independent Health’s continues its commitment to transform health care to achieve the Triple Aim of better health, better care, and lower costs.

Independent Health is closely following congressional activity. As efforts continue locally and nationally to reshape health care and health coverage, Independent Health will keep you up to date on developments.

Visit this page for updates and resources about the future of the Affordable Care Act.

The Repeal of the Affordable Care Act: what does it mean?

On January 4, the U.S. Senate took the first step toward repealing the ACA by introducing a draft 2017 budget resolution, which both houses of Congress are expected to vote on and move to address legislation that will repeal and replace specific provisions.

The resolution includes instructions to congressional committees to begin drafting legislation, called budget reconciliation, which will effectively repeal specific provisions of the ACA. Reconciliation legislation can impact only tax and spending issues. Provisions that do not have a direct budget impact would not be affected by the budget reconciliation process, such as the provisions that established Essential Health Benefits and coverage for pre-existing conditions.

Based on previous reconciliation bills vetoed by President Obama last year, Congress could include the following in a new bill:
  • Termination of funding for health insurance exchanges in U.S. territories;
  • Termination of the collection of fees and making payments under the transitional reinsurance program (which were established to shore up the small group markets);
  • Repeal of premium tax credits and cost-sharing subsidies;
  • Repeal of the small employer group health insurance tax credits;
  • Elimination of the individual mandate penalties and employer shared responsibility payments;
  • Repeal of Medicaid ACA expanded coverage for adults;
  • Elimination of ACA taxes, such as the “Cadillac Tax”; tax on medical devices; fees on manufacturers and importers of brand name drugs; annual health insurer fee; indoor tanning services tax; additional Medicare payroll tax for high wage earners; investment income excise tax;
  • Expansion of the use of Health Savings Accounts, Medical Spending Accounts, Flexible Spending Accounts, and Health Reimbursement Accounts to include paying for over-the-counter medications;
  • Revision of the medical expenses deduction.

The new congressional bill will also include effective dates for the implementation of the provisions, which, according to House Speaker Paul Ryan, will likely be delayed. In a recent New York Times article, Ryan said, “The point is, in 2017, we don’t want people to be caught with nothing. We want to make sure that there’s an orderly transition so that the rug is not pulled out from under the families who are currently struggling under Obamacare while we bring relief.”

While the repeal of the ACA may not result in an immediate loss of coverage, Independent Health echoes the call by other health insurers for Congress to find solutions that deliver short-term stability and long-term improvement. We support efforts that will maintain cost-sharing reductions, Medicaid expansion and other solutions while protecting consumers and taxpayers.

As Congress determines the future of the ACA, Independent Health is certain of the need for all stakeholders to continue working collaboratively to rein in costs and make our delivery system more efficient and effective as part of the ongoing effort to transform and reshape health care. Independent Health will continue to develop and enact solutions with key stakeholders, such as implementing value-based care, that will move the community toward better health, better care and lower costs.