American Health Care Act (AHCA) - Does it have a future?

The AHCA draft was approved by the House Ways and Means Committee and Energy and Commerce Committee on March 9, 2017. The bill was scored by the Congressional Budget Office (CBO) and went through a number of amendments and rescoring and was scheduled to be voted on by the full House on March 27, which was delayed to March 28 as negotiations for changes continued. The vote was ultimately canceled late on March 28. The bill had failed to get the support necessary to pass the House.

Speaker of the House Paul Ryan and the Trump administration announced that the country would be living with the Affordable Care Act (ACA) for the foreseeable future and that Congress was moving on to tax reform. Ways and Means Committee Chairman Kevin Brady (R-TX) said that the committee has been working on tax reform in parallel with health care reform and will advance legislation yet this spring. Treasury Secretary Steven Mnuchin has talked about August as a target date for tax legislation.

Secretary of Health and Human Services (HHS) Tom Price said in a subcommittee hearing on the HHS budget, when asked if the Trump administration still wanted to repeal the ACA, that the current system is not working and, “We have to fix the problem.” HHS and Tom Price will be critical to the success of ACA or whatever legislation may be coming to repeal, replace, or fix the ACA.

There is much speculation about whether or when health care legislation will be advanced, but the Trump administration, Congress, and HHS are not committing to anything and not revealing any specific plans.

Tom Price has said, “So long as the law is on the books, we at the department [HHS] are obliged to uphold the law.” The bill’s failure leaves the ACA employer mandate in place, as well as the coverage and offer rules for insurers and employers. So the compliance challenges will continue for employers subject to these rules (employers with 50 or more full-time equivalent [FTE] employees).

What has changed is the leadership of HHS, Department of Labor, and Treasury, and it is anticipated the regulations and enforcement from these agencies will be more employer friendly. The agencies also have been directed by executive order to review regulations and make changes to ease the burden on employers and individuals.

Employers have been in a wait-and-see mode with their decisions regarding health care and the ACA. The latest developments indicate that for the foreseeable future (i.e., for at least this year) employers will need to remain compliant with the ACA. Affordable health coverage must continue to be offered to full-time employees of employers with 50 or more FTE employees, or employers risk employer mandate penalties. Reporting of offers of coverage and actual coverage will need to continue so the federal agencies can enforce the employer and individual mandates and administer premium subsidies on the state Marketplaces.

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