KOLOA, Hawaii — One can be sure that some provisions of the Affordable Care Act will be repealed and some will be replaced – that is the state of politics, according to a speaker here.
Another thing to be sure of is that there will be delay, Allison W. Shuren, MSN, JD, said at Hawaiian Eye 2017. “This is not going to happen in January,” she said. “We have set some things up for change, but this is going to be a multi-year ride.”
There are about 20 million Americans who have signed up for the health care plans through exchanges, and about 13 million Americans with coverage through Medicaid expansion, she said.
“That’s a lot of people who we can’t just close the door on,” she said. “How to repeal and protect ought to be the other piece of the challenge here.”
Legislative options are to repeal the ACA and delay the effective date until after 2019, then develop a replacement plan; develop a replacement plan that can be passed through reconciliation without support of Senate Democrats; or develop a replacement plan through the regular Congressional process, seeking votes of Senate Democrats and endorsement of health care stakeholders, according to Shuren.
“I think we’re going to see a little bit of all three,” she said.
Likely targets of a new plan would repeal individual and employer mandates, repeal spending on premium tax credits, repeal or revamp Medicaid expansion, reduce or eliminate tax deductibility of health insurance, expand health savings accounts and address drug pricing, according to Shuren’s presentation.
“It’s going to be a daunting couple of years. Hang on for the ride,” Shuren said. – by Patricia Nale, ELS
Shuren AW. The journey ... moving from Obamacare to Trumpcare. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.
Shuren reports she is a partner in the office of Arnold & Porter Kaye Scholer LLP with clients who are manufacturers of products and services as well as providers of services.