Ever since the 2016 election, the healthcare industry has speculated on the type of legislation with which the Trump administration would replace the Affordable Care Act (ACA). On March 24 President Trump was dealt a big loss in regards to healthcare reform when his bill, the American Health Care Act (AHCA), designed to repeal and replace the ACA, was pulled from a vote on the House floor. Trump and key proponents tried to rush this bill through Congress, Republicans were divided and unsupportive of it, and, as a result, nothing happened.
For some legislators, problems with the bill included causing an estimated 24 million people to lose insurance in the next decade, and raising insurance costs for people in their 50s and 60s. For others it did not go far enough in reducing the deficit and lowering premiums.
That means that the ACA will be around for the foreseeable future. So with the ACA still standing, what can we expect moving forward? Here are a few ideas:
- The Republicans might try to implement reform to “fix” the parts of the ACA that they think are not working. This could involve small healthcare provisions in other pieces of legislation, or working with Democrats to get them to agree to include certain parts of the AHCA in future bills.
- In certain markets, insurers will stop selling insurance coverage under the ACA. We’ve already seen UnitedHealth, Aetna, and Humana drop out of exchanges in multiple states, and we expect this trend to continue. In small and rural areas there are fewer insurers competing to offer healthcare, and in some extreme cases, no available carriers at all.
- With uncertainty over what comes next with “repeal and replace,” it’s difficult to predict what’s in store for 2018 as far as insurance premiums go. Higher premiums continue to burden those who do have coverage and there is little sense that this will change. It’s expected that insurance premiums and out-of-pocket costs will keep rising.
- There have been calls for flexibility under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Timelines, measures, and reporting periods could be changed. But don’t expect much to be different, due to MACRA’s bipartisan support. Its continued implementation, in some form, seems almost guaranteed.
It’s still too early to know just what will happen next, but no matter what the current administration decides to do, experts predict they have a short window of opportunity to propose legislation again before the midterm elections in 2018. While healthcare remains a dynamic issue, bureaucracy and partisan politics remain as impediments to meaningful advances.
Don’t wait and see. Though the new administration hasn’t provided direction yet on how healthcare will be delivered, MACRA still stands. For more information on how an electronic health record (EHR) can help your practice prepare for current MACRA reporting requirements, contact us at 1.888.835.3409.