Notwithstanding loud political blustering, the Affordable Care Act is still very much with us.  It is vital to understand what impact that has on all of us.

First, let’s remember there are four principal parts to the ACA: (1) the employer mandate, (2) the individual mandate, (3) the exchanges/marketplaces for some individuals, and (4) free Medicaid for low-income Americans in 32 States.

The ONLY part of the ACA addressed in the (Wealthy Political Donors’) Tax Cut Act was the repeal of the individual mandate, which required that almost everyone had to buy health insurance.  However, even this single change does not happen until January 1, 2019.

The other 3 parts remain untouched, (1) there is still the employer mandate that says all employers with 50 or more employees must provide affordable insurance with certain essential benefits to full time employees, (2) there are still governmental health care marketplaces/exchanges where individuals earning less than 400% of the federal poverty level can receive generous subsidies to help with the cost of insurance premiums and benefit bills, and (3) millions of Americans in 32 States still will receive free Medicaid.

Moreover, none of the ACA’s primary impact parts for Taft Hartley Funds were changed—things like coverage even where there are pre-existing conditions, coverage up to age 26 for dependents, fines for employers who don’t provide coverage, and perhaps most surprising, the 40% excise tax on higher priced plans starting in 2020.

So apart from all the loud-mouthed mendacity and verbal flatulence we are now used to from Washington D.C., what will all this really mean? Pretty simple.  In the near future, it means there will probably be higher premiums for all of us to cover the costs of newly uninsured Americans (who don’t buy health insurance now the individual mandate is gone) who show up at emergency rooms for care. And insurance companies will also use “uncertainty” about the ACA to raise premiums “just in case” the market gets “shaky”—whatever that may or may not mean.

It also means, in the longer range, that by adding $1.5 trillion to the national deficit over the next ten years, primarily to benefit the super rich and corporations, there will probably be renewed noise to cut Medicaid/Medicare, and maybe Social Security, to “cut the deficit.” 

Of course, how this will all play out depends in large part on what happens in the November 2018, Congressional elections. The recent tax bill was passed without a single Democrat’s vote. It was jammed through by Republicans who may know their days are numbered and that after November 2018, they may lose control of Congress and be unable to do any more damage to social benefit programs like the ACA, Medicaid and Medicare, and Social Security. All of that, of course, is a matter of speculation, as is what each of us may choose to do about these coming elections.

For more information, please contact your labor law or benefits counsel. 

By Bill Sokol | January 19, 2018

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