By: Brady Bizarro, Esq.

The dog days of summer have come and gone and there are still many questions left unanswered regarding the future of the Affordable Care Act (“ACA”). Congress is in its summer slow and President Trump’s plans for the ACA’s upcoming 2017-2018 enrollment period remain a mystery. There are millions of Americans in the individual insurance market who are not certain whether or not they will be able to get minimum health coverage from the precarious ACA insurance market. For employers, it still remains unclear which ACA regulations the Trump Administration will enforce and which it will not. A lot has happened thus far in the repeal and replace saga, and it is worth a recap of how we got here; once again, to a place of uncertainty.

Throughout July, the Senate voted on five repeal and replace bills, all of which failed (one by a margin of only one vote). The first bill, and perhaps the most promising for many House Republicans, was the American Health Care Act (“AHCA”). Next was the original Better Care Reconciliation Act (“BCRA”). This bill caused so much division that it was pulled from the Senate floor and underwent a series of revisions, including one from Senator Ted Cruz (R-TX). Then the Senate considered the Obamacare Repeal and Reconciliation Act (“ORRA”), which did not really provide a replacement strategy. Finally, the Senate considered “skinny repeal,” officially titled the Health Care Freedom Act (“HCFA”). This was the bill that went up in flames in a dramatic showdown involving Senator John McCain (R-AZ) on the Senate floor. In the end, we added a number of acronyms to the health care debate, but no actual progress was made.

With the administration and congressional Republicans poised to reboot repeal and replace efforts, the focus for now shifts to the White House as the individual insurance market teeters on the brink. While he did approve August subsidy payments, President Trump has threatened to end billions of dollars in cost-sharing reduction payments to insurance companies to subsidize the cost of care for low-income Americans on the individual exchanges. In addition, his administration has cut the ACA enrollment period in half, from ninety days to forty-five. This year, Americans will only be able to register for 2018 between November 1st and December 15th.  

These next few months will be critical, especially for the individual insurance market. The Senate is holding hearings in a few weeks to discuss strategies for stabilizing the exchanges. We will be watching to see how the administration reacts and what actions it takes that affect regulatory compliance. For now, however, as Speaker Ryan (R-WI) recently said, “Obamacare is the law of the land.”