Affordable Care Act Survives! What’s Next?

All the Republicans in the U.S. Senate marched in lockstep with Mitch McConnell, except for Susan Collins, Lisa Murkowski, and John McCain, but that was enough to bring an end, for now, to any attempt to repeal, replace, or otherwise gut the Affordable Care Act (“Obamacare”). Republicans sought to pass their “skinny repeal,” which would have left 16 million people without healthcare, raised health insurance premiums, and destroyed access to comprehensive healthcare for many women by defunding Planned Parenthood. This attempt failed.

So what happens now? Probably nothing wonderful.

The enrollment period for 2018, for those who do not have health care benefits through their employment, has been drastically reduced to six (6) weeks, so Unions, community organizations, and volunteers are going to have to make an all-out effort to get as many people as possible enrolled in either the Exchanges/Marketplaces or free Medicaid. The Exchanges/Marketplaces are available for anyone earning from about $16,700 to about $45,000 a year, and the free Medicaid is available for any individual earning less than about $16,700. Tax credits and subsidies should be available to help manage the costs for these enrollees.

More problematic, though, is the fact that HHS Secretary Tom Price despises Obamacare, and there are over 1,000 places in the Act which allow him to exercise his discretion to either improve or undermine the law—and Price has promised he will look at every one of these. So he may make it very difficult for enrollment to happen, and for those enrolled to get the care they need.

In addition, the IRS has already announced it will not enforce the individual mandate, so no one is really required to have health care insurance, which will mean the youngest and healthiest of us may decline to purchase insurance, making it more expensive for the rest of us.

Most problematic, as the wheels come off the Trump Trolley (if they were ever on in the first place, after he lost the popular vote by millions of votes), he may choose to stop funding the Exchange/Marketplace subsidies that make reduced costs possible for the least wealthy among us, and this may lead to further increases in the cost of insurance.

What does this mean for workers who earn health care benefits through their employment? It means two things: first, there is still a lot of work to be done to preserve health care benefits for the 20 million who were added to the rolls by Obamacare, and it also means that premiums will probably start racing up again, so careful attention will have to be paid to preserving benefits in the face of rising costs.

What are some ideas developing now?

  • Click here, for an article on bi-partisan legislation that could lower premiums and stabilize insurance markets.

  • Click here, for an article on a more comprehensive alternate health care reform bill developed by twelve Senate Democrats earlier this month.

  • Click here, for an article on lowering prescription drug costs by increasing competition among pharmaceutical companies.

We will try to keep you fully informed on the many twists and turns we now expect as new regulations and rules are issued, and old ones are withdrawn or superseded.

Stay tuned—and make sure to talk to your legal counsel when you go into benefits bargaining!


Author: Bill Sokol & Adam Thomas

Justin Mabee

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