Let’s start out with one of the few things we know for sure about ACA: it is still the law of the land. Yes, essential health benefits, measurement periods, affordability safe harbors, 1095-C’s, etc. are all still part of our lives. For now.
Many questions remain. Questions like: will the ACA implode as we hear so often in the media? Will premiums rise again? Will there be an exchange in my state, my county?
Today, more than 5% of Americans receive coverage through the individual marketplace and all these questions are valid. But, because the law hasn’t changed, we are hopeful that we will continue to see individual coverage in most locations. We can’t promise premium relief, but there continue to be many insurers that are willing to provide coverage. And remember, Washington’s primary focus is on the individual market. Most brokers work today exclusively in the small and large group market where greater stability exists.
Why did the Senate bill fail?
Despite a House bill, why couldn’t the Senate deliver on their promise of “repeal and replace”? Quite frankly, both the House and Senate learned what we have known all along - health care, and more specifically health insurance, is complicated. But it's more than that. Many provisions of the ACA are quite popular among voters – both Democrats and Republicans. Also, both parties have long been on separate sides of the healthcare debate and without a bipartisan effort, small fractions in either party will result in defeat. And let’s face it – it’s hard to take something away from people – especially if they really like it.
Because the Senate used the reconciliation process and failed, they now must need 60 votes to pass a bill during the current session. That itself will force them to reach across the aisle to bring change to the ACA. While we are optimistic that we might see incremental changes on those “fixes” to the ACA where there is little disagreement on, larger changes will have to wait.
Meanwhile, the 4th quarter renewal cycle is rapidly approaching and we must again focus on our small and large group customers. Continue to remind your clients that the ACA is still the law of the land, refresh them on waiting periods, reporting, and 2018 affordability safe harbors.
This is an evolution. Each of us must be more committed than ever to serving our clients and working together to bring solutions that create market stabilization and premium relief while continuing to ensure access to care.