Going into President Trump’s speech Feb. 28 before a joint session of Congress, I was curious to watch, as there has been a lot of division between moderate and conservative factions of the Republican Party throughout the Affordable Care Act’s repeal and replace process.
While Democrats have been united in keeping the ACA, Republicans have been split with what to replace it with. On Feb. 26, media outlets reported that at some point this week, more conservative Republicans might introduce a bill relevant to what they want, almost a dare to moderate Republicans to vote on something they don’t necessarily agree with in order to finally repeal Obamacare.
On Feb. 28 before the address, ABC News reporters mentioned that Republicans are desperate for leadership from the president. Following Trump’s comments on the ACA, in which he cited six key principles, it’ll be interesting to see what congressional Republicans take to heart, if it helps mend the division at all and how these principles could impact employers and employer-based health care plans.
Of the health care reforms he called out, what most applied to employers are the increased use of tax credits and health savings accounts to help with health care costs. He also advocated for decreasing the cost of pharmaceuticals and increasing competition in the health insurance market across state lines.
A few health care experts in my Rolodex contributed to their thoughts on the address: What were the employer takeaways?
“It’s still not certain that the ACA will be repealed and, even if it is, employers will not feel a huge shift as the majority of the most impactful reforms are geared toward the individual and public/state-based markets,” said Shan Fowler, senior director of product strategy at Benefitfocus, in an email. “They may see some regulatory relief in the short run but the general complexity and cost pressures are not likely to vanish overnight — and probably not at all.”
He also mentioned that as insurance costs rise, which they are likely to do with or without the ACA, providing employees with access to an HSA will help them pay for increasing health care costs. A recent Benefitfocus report found that contributions to HSAs are rising, especially among millennials, and that this trend is likely to continue. “We may even be close to a world where every plan can and should have an HSA, which would be a good thing in among the general uncertainty,” Fowler said.
Trump also signaled that a replacement plan for the state exchanges and the Medicaid expansion is still on his agenda, but that it may take longer to accomplish, said Steve Wojcik, vice president of public policy at the National Business Group on Health, in an email statement. The goal is to protect the people currently covered by the exchanges but transition them to different coverage over time.
Trump only briefly talked about the ACA, and 45 minutes into the speech, which indicates that he recognizes that there are no quick fixes in Congress, Wojcik added.
“For employers and their health care benefit programs, it’s business as usual until any formal legislative proposals surface and Congress acts on those,” he said. “Additionally, to the extent that employers have employees or retirees on the exchanges or covered by the Medicaid expansion, the speech may reassure them that these populations will likely have minimal disruption in coverage during the transition to the post-ACA world.”
Andie Burjek is a Workforce associate editor. Comment below, or email firstname.lastname@example.org. Follow Workforce on Twitter at @workforcenews.