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The GOP wins the Senate – implications for ACA

While by no means certain, it looks as if the GOP is going to gain control of the US Senate in January.  What, if any, are the implications for PPACA?

There’s a good piece in today’s California Healthline digging into the issue; it cites two potential priorities for a GOP-dominated Congress.  Slowing or continuing to delay the employer mandate, and eliminating/ravamping the risk corridors seem to be the most likely approaches.

However, there’s a bit of political risk in that, as many GOP backers want ACA repealed; they may see “fixes” as compromise, a very bad word these days among conservatives.

While some will argue that a GOP Congress will push for repeal, I’m not so sure. With about 10 million more Americans covered under PPACA, that’s a lot of voters that might be upset if their coverage was yanked out from under them.  There are any number of provisions that are quite popular – covering children to 26, eliminating lifetime dollar caps on expenses, no-cost preventive care, no medical underwriting come to mind. Any move to go back to the bad old days would result in a lot of angry insureds.

Delaying the employer mandate is much more attractive politically; small business people would generally like it, the President has already done this so there’s precedent, and it isn’t that hard to do.

The risk corridor is a much tougher task.  Insurers would lobby very hard against it; while opponents of corridors make the argument that they are simply a taxpayer bailout of the insurance industry, politically speaking it might well by toxic.  It could potentially lead to higher premiums and fewer health plan options, both of which would likely be used against the GOP in the next election – which is a mere 24 months away.

Of course, the Tea Party Reps in the House may follow a “damn the torpedoes” strategy, which would result in a vote to repeal ACA, followed instantly by a Presidential veto, thereby setting up two more years of gridlock.

IF that occurs, and IF voters get into a “throw all the bastards out” mode, the GOP may find itself right back in the minority in the Senate; of the 34 Senate seats up in 2016, 24 are currently held by the GOP.

What does this mean for you?

Depends on voter turnout...




Joe Paduda is the principal of Health Strategy Associates




A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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