9 Ways the GOP May Attempt to Modify the ACA in 2015

Sunday, January 4, 2015

The 2014 mid-term elections produced a landslide victory for the GOP.  It is the first time since 2006 that the GOP has had a majority in both houses of Congress.  With many new members campaigning on promises to reform/repeal the ACA, it is likely that legislation of some kind will be drafted.  Whether or not these reform bills make it to the House and Senate Floor, become bundled with other proposals, get vetoed by the President or become bargaining chips in government funding negotiations is speculation.  But the following is a list of some specific aspects of ACA that may be addressed in some fashion by the politicians in Washington:

·         A Full Repeal – While success is highly unlikely while President Obama is in office, a full repeal vote is a core principle to many in the majority.  It has been attempted before and probably will be again.

·         The Medical Device Tax – This is a 2.3% sales tax on medical devices imposed on the manufacturer or importer of the device.  Efforts to repeal this tax have already taken place and this is an area where many in both parties agree and a bi-partisan effort to modify this component of ACA is quite possible. 

·         IPAB – The Independent Payment Advisory Board is intended to come up with recommendations to Congress on how to lower Medicare spending when the program’s per person spending grows too quickly.  As of yet, Medicare’s cost growth has been too slow for the panel to convene and it has no appointed members.  Legislators in both parties have taken aim at the IPAB accountability measures and fear its potential harm to seniors.  IPAB elimination would likely be on a short list of bills that have bi-partisan support.

·         30-Hour Rule – The ACA defines full-time employees as those working 30 hours a week.  The employer mandates of ACA are predicated on this definition.  Many legislators would like to see this definition changed to 40 hours a week.  Their case is that a 30 hour week is unreasonable and is causing businesses to slash employees’ hours.

·         Individual Mandate – The individual mandate is the requirement that non-exempt citizens enroll in ACA qualified health insurance or risk being fined.  Although the individual mandate was upheld by the Supreme Court, it remains one of the least popular components of the ACA with the public. 

·         Employer Mandate – The employer mandate is a requirement that all companies with more than 50 full time employees provide affordable qualified health insurance or pay a fine.  Critics say that the mandate encourages a transitioning to more part-time employees and discourages work force growth. 

·         Cadillac Tax – The ACA levies a 40% marginal excise tax on high-cost employer sponsored health insurance beginning in 2018.  With a deadline well into the future, Congress may wait to address the “Cadillac Tax” concerns after the 2016 election.  But the current opportunity for bi-partisan support for modifications vs. repeal of the “Cadillac Tax” may see it addressed this upcoming term.

·         Copper Plans – These plans are of lesser value than bronze plans and cover 50% of a typical person’s medical bills. There may be bi-partisan support to make such plans ACA qualified to help lower costs.

·         Health Insurance Tax – The health insurance tax is a fixed tax allocated across all insurers by their market share.  The statute calls this tax an “annual fee.”  Co-sponsors have already begun lobbying the repeal of this provision.


This list is meant for informational purposes only.  Predicting what will actually come to fruition is impossible where the Federal government is concerned.  But ACA remains very unpopular and changes may be coming.