A repeal of the ACA has probably been a singular focus for the Republicans since 2010, ever since they launched their first attempt to replace the law with their alternative. After countless attempts to repeal and replace the Affordable Care Act, the GOP had to bow down to the ultimate success gathered by the law after a botched rollout last year. With formidable enrollment numbers and extended benefits through the law, it seemed nearly impossible for the GOP to take the law down in time.
However with a Republican-majority Senate, it looks like they have a strong opportunity to put their old plan in action and replace ACA with something endorsed by the party. The GOP taking a different approach to tearing ACA apart bit by bit – targeting the most unpopular provisions of the law and splitting them open with targeted legislation that could gather sufficient momentum. Here’s what could happen to Obamacare if a GOP Senate gets its way.
With this majority, the GOP plans to put in resolutions to repeal the entire law and, if that does not work, targeting the major taxes and penalties under Obamacare that are inacceptable to the party. The GOP still feels that it is necessary to break the law down as some provisions of ACA are mere unworkable expansions that will increase healthcare costs across the country, and will hurt employment, economy, and business growth.
The section of ACA receiving the strongest ire from Republicans is the employer mandate. The employer mandate requires businesses with more than 50 employees to provide health insurance coverage to employees, failing which they will be subject to penalties. The GOP feels that these aspects are hurting job growth in our economy, in turn hurting our people. Other than the workings of the employer mandate, the Republicans also want to target the gray area presented by the definition of ‘fulltime’ workers in ACA. Other than these primary aspects of the law, the Republicans will also focus on excise tax on medical devices, CAT scan machines, MRI machines, etc. The compensation for market losses to health insurers might also come in the line of fire.
The Republican efforts are drawing power from the business community’s constant lobbying efforts against employer requirements, penalties and taxes. Medical device manufacturers have continually spoken against excise duties, giving more firepower to Republicans. Amid this, some Democratic senators have also discussed supporting certain Republican measures. It looks like once the repeal efforts come to play, some negotiations might be possible between Republicans and Democrats, and the White House might not be able to veto every move of Republicans.
There are chances of a middle path being established on some attacks by Republicans, for instance, the tax penalties on employers who do not offer health coverage to employees might be replaced by incentives for employers who do. While the all out Obamacare repeal agenda will definitely be pushed off the floor, the seemingly minor alterations to the law might not be that easy to forgo.
As the ACA faces another Supreme Court case where the federal subsidies in states that did not opt for their own exchange are being reconsidered, this looming challenge might be a tough nut to crack. Unfortunately, a powerful act that has the potential of changing health insurance forever might succumb to mounting pressure from the opposition.