ACA: Here We Go Again
Well, that didn’t take long.
Following the demise of the Senate's Graham-Cassidy Bill in September, many thought the repeal and replacement efforts of the Affordable Care Act (ACA) were complete. For now, that’s correct – the Republicans have moved on to tax reform, and that’s the primary focus of Congress. However, that doesn't mean the administration is done with the ACA. Indeed, in the last week, the White House has made significant moves with respect to the ACA, including:
- Changing the rules that require employers to provide contraceptives to female employees with no cost-sharing;
- Directing the DOL, Treasury and HHS to examine rules that will make it easier for individuals to purchase insurance across state lines, allow small employers to establish association health plans, and loosen the restrictions on health reimbursement arrangements; and
- Announcing the administration will cease making payments to insurance carriers for the cost-sharing reduction program.
What do these actions mean? In my mind, this was always going to be the second act in the grand plan to move away from the ACA. Remember, it became evident very early in the Trump Administration that a flat repeal of the ACA without any replacement wasn’t realistic, and the pivot was to a three-part plan: first, repeal major sections of the ACA, but provide a two-year off ramp; second, make regulatory changes that congress couldn’t make due to the restrictions imposed by the reconciliation process being used; and then finally, design and implement the successor to the ACA. Of that grand strategy, only the third part remains for now, and the administration is moving ahead with it.
That’s all well and good, but what does it mean for you, the employer? Right now, not a whole lot outside of the contraceptive change (which may or may not be an issue for you, or even an option if you’re publicly traded). The executive order signed yesterday is just a to-do list really – it represents no changes at this time. The elimination of the cost-sharing reduction funding is a blow to insurance carriers for individual carriers, and it took all of approximately 12 hours for many states to file lawsuits seeking to put a stay on that decision (meaning by the time you read this, the courts may already be taking this issue up and forcing the White House to continue payments).
For now, as has been the case all year, the message is the same: nothing substantial has changed. You may no longer need to cover contraceptives without any cost-sharing, but otherwise the employer mandate, the individual mandate and all the other pieces of the ACA remain in force. Within the next 60 to 120 days, we do expect to see additional regulations that result from the executive order, and then we’ll have a better feel for what’s coming next. In the meantime – keep on moving ahead with your ACA plans, and reach out to us with questions.
Information contained herein is not intended to constitute tax or legal advice and should not be used for purposes of evading or avoiding otherwise applicable regulatory responsibilities as issued by the federal or state government(s) and/or taxes owed under the Internal Revenue Code. You are encouraged to seek advice from your legal or tax advisor based on your circumstances.
- ACA Contraceptive Requirement Changes
- What's Next for ACA Compliance? Webinar Replay
- The ACA Is Here to Stay - For Now
- Compliance Support Page