Proposed Changes to Employee Benefits Trump Could Bring

The Challenges of Repealing the Affordable Care Act

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In the first few months since President-Elect Donald Trump has begun work on his promised health care reform of the Affordable Care Act, already he’s coming up against critics who say it will take years to make any progress. Criticized by many over the years for its tax penalties and high premiums, the ACA introduced Americans to universal health care coverage. A large part of Trump’s campaign was spent breaking the ACA and Obamacare down to expose its flaws and demand a repeal.

What's in Store for Employee Benefit Changes in the Coming Year?

Republicans are supportive of the effort to improve employee benefits and health care insurance, however, they have indicated that they acknowledge the lengthy and complex process that it will take to reform and replace Obamacare. Trump appointed U.S. Representative Tom Price, R-Ga to replace Sylvia Burwell as the Secretary of Health and Human Services, and he is a strong supporter of healthcare reform. Price could push for ACA repeal and limit any further implementation while it’s in place. In a speech in October 2016, Price said, “You should be free to pick whatever insurance plan meets your needs, not one Washington forces you to buy.” (Source: NBC News)

Some of the challenges of repealing the ACA include:

What to Do With 20 Million Americans Already Enrolled in Obamacare-Qualified Plans

According to the most recent figures, there are around 20 million Americans currently enrolled in Obamacare plans.

This includes 12.7 million who enrolled through state marketplaces, as well as students who remained on their parents’ plans, Medicaid provisions, and private insurers. Unlike some people fear, there will not be a massive migration of all ACA approved plan members to some unknown program that Trump puts into place.

Instead, the move may take months and even years as consumers are given the option to remain insured through the new network of affordable health care companies and providers. No doubt, there will be some incentives to do so.

How to Get 11.9 Percent Uninsured American Adults to Enroll in Trumpcare

One of the bigger challenges that the new administration can expect to face is how to get the remaining eligible citizens of the USA to enroll in revised plans. Over the course of the roll-out of Obamacare, the rate at which people enrolled was painfully slow. In its final year, the largest number of enrollees totaled 12.7 million consumers for the 2017 plan year. Many people waited until last minute to enroll in plans using their state exchanges or to select plans. Then there are the nearly 12 million of consumers who outright refuse to enroll in any type of government subsidized health care plans. These consumers range from those who are either unfamiliar with the rules surrounding the Affordable Care Act, or they don’t want to be part of a government program, opting for self-pay medical options and alternative health care services.

This seems to be the trend when consumers are given the opportunity to select their own health care plans, and is something to be expected by the new administration too.

During his campaign, a survey of Trump supporters was taken in multiple regions and The New York Times highlighted the wants and needs of consumers.

  • A desire for less complexity of plans, deductibles, co-pays and more
  • Health care insurance that’s actually affordable given the current cost of living and wages
  • No more surprise medical bills and more transparency of plan terms
  • More affordable drug costs, more coverage for drugs and medical treatments
  • Plans that are better or at least equal to the benefits low-income health insurance offers
  • What actions should be taken regarding insurance companies that have inflated rates
  • Elimination of the tax penalties for those who cannot or do not want insurance

Perhaps by focusing on these areas of consumer demand, the new administration will be able to overcome barriers to enrollment in new plans.


Democrats Won't Let Repeal Happen Too Soon

The other challenge that exists in Washington DC is the support of Obamacare by Democratic representatives in office, albeit in the minority currently. They will not make it easy for the new administration to pass repeals to the existing health care plans, which took years to approve. 

Some experts are saying that it’s not as straight forward as making swift changes, because Republicans will come up against much resistance from Democrats. Three proven successes of the Affordable Care Act prevent this.

  1. Enrollment of Obamacare is historically at it’s largest rate ever, so how will repeal help Americans who are enjoying access to health care now?
  2. The stated goals of repeal are impossible. Much more research and work needs to happen to develop a clear plan of action.
  3. The political fall-out could be a disaster and more Republicans will join the ranks of Democrats in refusing to vote for repeal. 

What Changes Could Trumpcare Bring to the US Health Care System? 

There has been much speculation throughout the Trump campaign and now that he is in office, accurate information about what his planned for repeal is unclear. However, some sources say that health care reform may look something like the following: 

  • End of the government's requirement to purchase health care
  • A free and open market that allows more choices for consumers (including the choice to buy plan across state lines)
  • Individuals' ability to deduct the full cost of health plan premiums on annual tax returns
  • Continuance of tax shelters in the form of health savings accounts
  • Full price transparency by health care providers to give consumers more purchase power
  • Giving states the ability to self-manage Medicaid plans
  • Promote free markets for drugs and expensive medical procedures

All of these features are welcome to the millions of consumers who rely on health care to create healthy and strong communities. However, it will take much more work before any repeal will happen and the above factors could change. We will revisit this topic at a later date to see if any of the predicted changes have taken place and if health care reform is working in America.