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The Trump Presidency and the Fate of the ACA

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The Trump Presidency and the Fate of the ACAThe Republicans have sought to dismantle the Affordable Care Act long before President-elect Trump set his sights on the Oval Office. In 2010, shortly after the health care law’s passing, the GOP took control of the House. Since that time, they have held more than 60 votes to repeal it.

During his 16-month campaign, Trump has vowed repeatedly to scrap the law entirely saying things like “Repealing Obamacare and stopping Hillary’s health care takeover is one of the single most important reasons that we must win on November 8” and “It’s over for Obamacare.” And they planned to move quickly, reportedly considering convening a special session of Congress solely for the purpose of repealing it.

The Democrat Response to Trump’s Win

“On day one of the Trump Administration,” his campaign website touts, “We will ask Congress to deliver a full repeal of Obamacare.” Democrats, as a result, are scrambling to mobilize efforts in defense of President Obama’s Affordable Care Act.

Advocacy groups are waging “total war” to defend Universal Healthcare, understanding the difficult path that lies before them. “We’ve got the battle of a lifetime ahead of us,” executive director of advocacy group Families USA Ron Pollock told Politico following Trump’s election, soothing mounting fears within the party by adding “We’re going to have a huge number of organizations from all across the country that will participate in this effort.”

Democrat aids have echoed a similar sentiment without detailing their strategies to prevent repeal or large-scale changes, saying only that defending the ACA is a top goal for them throughout the Trump presidency.

While dismantling the ACA is referenced as a top agenda for Republican lawmakers, the same passion seems to be propelling a Democratic party into defense mode. 

The Four R’s

While the term “repeal” has been cited the most throughout his campaign, the Republican position can be more accurately described as “retain, remove, replace, and reduce.”

Since the election, Trump seems to have softened his position. “Either Obamacare will be amended, or repealed and replaced,” he said shortly after the election.

Why is he now open to compromise? According to an exclusive interview with the Wall Street Journal, the big reason was his meeting with President Obama on November 10th. During their talk Obama suggested to him areas of the Act to preserve. “I told him I will look at his suggestions, and out of respect, I will do that” Trump said.

Trump has already pointed to two things in the law that he wants to retain: the prohibition against insurers denying coverage because of patients’ existing conditions, and a provision that allows parents to provide years of additional coverage for children on their insurance policies. “I like those very much,” he has said.

What about the remaining three Rs? The Cadillac Tax, the ACA’s 40 percent excise tax on high-cost health insurance slated to go in effect in 2020, will likely be removed; replaced would be the requirement that all exchange health plans offer a defined 10-category essential health benefits’ package; while the law’s individual and employer mandates will likely be reduced.

Too soon to tell

While just how much of the ACA will be retained, removed, replaced, and reduced is still up for speculation, there’s no doubt it will be a long and bumpy ride for all. Nothing will happen immediately, so employers should plan to comply with the ACA in the same way they have before the election.

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