Last month, President Donald Trump issued an executive order for minimizing the burden of the Patient Protection and Affordable Care Act (ACA), pending repeal.
In the order, he said, “To the maximum extent permitted by law, the Secretary of Health and Human Services [HHS] and the heads of all other executive departments and agencies with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty or regulatory burden on individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products or medications.”
In a letter to Trump, American Benefits Council President James Klein said, “The Internal Revenue Service [IRS] can provide relief to employers without negatively impacting individual taxpayers. Such relief could be applied swiftly and immediately.” The council’s letter suggests interim solutions in light of anticipated legislation to “repeal and replace” the ACA.
However, Steve Wojcik, vice president of public policy at the National Business Group on Health, in Washington, D.C., says until there is a permanent HHS secretary in place, not much can be done. He notes that it will take some time to propose rules, put out a request for comments and review them, then put out a final rule. “It could take months or half a year or longer, depending on how big the regulation was and how much needs to be changed,” he tells PLANSPONSOR.
But, he continues, it is safe to say that because of the executive order, it is unlikely there will be new regulations about the excise (or Cadillac) tax on high-cost plans. He feels it will be permanently tabled.
Wojcik adds that not much can be done through the executive order. Repealing mandates and federal subsidies for exchanges would require legislative action. Congress would have to get involved and would have to figure out what would replace exchanges and Medicaid expansion. “Right now, Republicans who control the house and senate are trying to figure out what replacement would be,” he says. “Plan sponsors should continue doing what they are doing; there is no change that will affect them now.”
Sheryl Simmons, chief human resources (HR) officer at Maestro Health, who is based in Detroit, Michigan, notes that currently the order does not apply to the rescindment of any existing regulations—it was only applicable to fiscal burdens. “At this time, the only actions that can be taken are those related to a fiscal burden on a state, individual, family, health care provider, health insurer, patient, recipient of health care services, purchasers of health insurance or makers of medical devices, products or medications,” she tells PLANSPONSOR. NEXT: Effect of repeals on plan sponsors