Jonathan Edelheit, CEO of the Health Care Reform Center & Policy Institute and Benjamin Conley, Partner at Seyfarth Shaw, and faculty member of the HCRCPI, convened yesterday morning to discuss post-election fallout regarding the National election and the impact on the Affordable Care Act and what a Trump healthcare reform law might look like. You can watch the replay of the webcast here.
Below are the key takeaways from their discussion:
- Can republicans actually repeal the affordable care act?
- The short answer is no.
- The Republicans do not have a filibuster-proof majority in Congress that will allow them to repeal and replace. This will require 60 seats where the republicans will have 51 – 53 seats in the senate.
- “Estimates are a removal of the law would result in coverage losses for 20 million people” reported Ben Conley in a webcast yesterday.
- A Republican congress and President-Elect Donald Trump can take two potential steps unilaterally without Democratic support which would undercut the effectiveness and “water down” the Affordable Care Act.
- With control of Congress, the Republicans can defund the Affordable Care Act. The law cannot operate without federal tax dollars to fund the marketplaces and regulation efforts.
- You may recall that in 2010 when the ACA passed that Democrats used a process called “reconciliation”. This process allows Congress to make modifications – or even pass the law – through tax provisions of the law. A Trump healthcare reform law can use this process to alter parts of the law – specifically the parts that pertain to taxes like the individual mandate, employer mandate, and exchange subsidies. This will not extend to the design-based provisions like the ban on pre-existing conditions exclusions or the adult child coverage mandate.
- In respect to potential replacements in lieu of the Affordable Care Act, you will probably see a cobbled–together hybrid of various provisions from the law that previously existed. Reverting back to a pre-ACA system is unlikely.
