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Big Changes Ahead for Affordable Care Act

January 25, 2017

Action by the new Congress and an executive order last week by President Trump foretell big changes in the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the ACA), or even its outright repeal and replacement with other legislation.

With the House passage of the Senate budget bill, certain committees have been instructed to complete a draft of the repeal legislation by January 27. It is unclear at this point what aspects of the ACA, if any, may be preserved in the repeal legislation, as various current and former members of Congress have proposed differing options.

In his executive order, President Trump states that it is the policy of his administration to seek the prompt repeal of the ACA. Pending the conclusion of the repeal efforts, the stated intent of the order is to efficiently implement the ACA, minimize unwarranted economic and regulatory burdens, and afford states more flexibility to create a freer and more open healthcare market.

Until Congress takes action to repeal part or all of the ACA, the status quo likely will continue for all aspects of the ACA on which formal guidance has already been approved. This means, for now, continued compliance with the following aspects of the ACA, among others:

  • the employer mandate and the penalties triggered by noncompliance;
  • the reporting obligations and IRS enforcement of penalties due from large employers who fail to timely and accurately report the coverage offered to employees and their dependents;
  • the market reform requirements (such as coverage for dependents up to age 26, no pre-existing condition exclusions, and prohibition of annual and lifetime limits) and IRS enforcement of penalties for non-compliance; and
  • the anti-discrimination rules and the enforcement of these provisions.