As Congress and the Trump Administration regroup after the failure of the Republicans’ bill to repeal and replace the Affordable Care Act, it’s looking unlikely that there will be another attempt — anytime soon, at least — to scotch the ACA.
But even if there is no such attempt, it’s not yet clear how enthusiastically the administration will support the ACA going forward. Policy options are available to interfere with the law’s optimal functionality and thereby make it more likely to “explode,” as President Trump has asserted that it will.
Already, after Trump took office, the administration pulled most marketing and promotional activities aimed at getting individuals to sign up for Obamacare through the public exchanges. Also, the White House could take any number of steps aimed at stabilizing the insurance market and thereby slowing or halting the exodus of insurance carriers from some of the exchanges — but will it?
Perhaps most effective, if the administration truly were bent on crippling the ACA, would be a refusal by the Health and Human Services Department, run by Secretary Tom Price, to appropriate funds from Congress for the subsidies for low-income individuals and families provided for under the law.
Some experts don’t believe the president will, in the end, allow Obamacare to explode. Even so, Congress on its own conceivably could act to repeal individual ACA provisions within the ACA.
But no matter what happens, most companies are not thinking of taking any opportunity to pull the plug on enhanced benefits that were created by provisions of the ACA, according to a survey of 666 U.S. employers from Willis Towers Watson.
The survey was taken in January, before the Republicans’ failed health-care bill was even proposed. But companies were asked about their sentiments should popular Obamacare provisions not receive federal support, and most of them said they intended to stand pat.
Here are some examples:
Unlimited lifetime benefits. Employers said they were more than three times more likely to keep them in place than they were to reinstitute lifetime dollar limits: 50% versus 15%.
Contraceptive care at 100%. Employers were nearly six times more likely to maintain coverage at that level than they were to reduce it: 59% versus 11%.
Age-26 dependent coverage rule. More than twice the number of employers would keep the eligibility age at 26 than those that would lower the age limit: 48% versus 22%.
Employer mandate to offer health insurance for full-time employees. Just 6% of employers said they were “very likely” and 13% “somewhat likely” to make changes to plan eligibility.
Restrictions on premium-reimbursement health savings accounts for active employees. Just 4% of employers were “very likely” and 13% “somewhat likely” to make changes to their current health-care strategy.
Limits on the dollar amounts of premiums for employer-sponsored health insurance that are exempt from federal income and payroll taxes. Just 16% of employers were “very likely” and 31% somewhat likely” to make changes if the tax exclusion is capped.
The 666 employers that responded to the Willis Towers Watson 2017 Emerging Trends in Health Care Survey represented 9.3 million employees, including 6.5 million full-time workers, across a variety of industries. Each participating employer had at least 200 employees.