The Top 10 Changes Coming to the ACA

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​Here are TBAs top 10 picks for the most likely changes to the ACA.

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​Congress is already plowing forward with their promise to repeal and replace the ACA.  While they may not be able to repeal the entire law in one fell swoop, they will definitely chip away at it while crafting a replacement. What they will replace the ACA with is still up for debate (even amongst themselves), but be prepared.  Once the inauguration day hoopla is over, you will see the recrafting begin – this is my top 10 watch list, in order of “most probable”:

1. Covering Kids to 26 – keep
   Everyone agrees on this one, at least for now
2. Employer Mandate – remove penalties and/or reporting
   Rid of Penalty A and Penalty B, effectively removing the mandate’s teeth
   Rid of reporting requirements, although won’t affect the current reporting required
3. Individual Mandate – nix
   But expect even higher premiums for 2018 as more healthy individual dump coverage
4. Individual Subsidies – change
   Most likely change to a tax credit or even continue as a subsidy
   But change to a flat amount, regardless of income
5. Guaranteed Issue – change
   Add pre-existing condition clauses for those with a break in coverage
   Slap a premium penalty onto those who don’t maintain continuous coverage
6. Medicaid Expansion – repeal
   Reduce from 138% of the Federal Poverty Level, to 100%
7. Essential Health Benefits – mixed
   Some favor removing all requirements for EHBs, others are mute on this issue
8. Health Savings Accounts – expand
   Most of the interest is in expanding HSAs to pay for premiums
   There is also some talk of raising the annual maximum deposit limits
9. High-risk Pool – resurrect
   Allow states to create high-risk pools again
   Possibly allow for a reinsurance fund to cover high-risk pool large claims
10. Selling Across State Lines – allow
    This will be difficult, since every state has their own mandates
    New rules would have to address this issue, which means it will take time to enact

Although the Senate voted just this morning to repeal the ACA.  it's anyone's guess how quickly we'll see changes agreed on, much less enforced.  Stay tuned.