With the completion of mid-term elections in November, I have been wondering what changes we should expect with the Patient Protection Affordable Care Act (PPACA). While Republicans spent the last two years looking for ways to repeal or weaken PPACA, Democrats campaigned during this most recent election on the promise to protect and strengthen the reform laws. Now that the dust has settled, we are left with Republicans retaining control of Senate (as well as Presidency) and Democrats are in control of the House. While no definite plans are in place, Democrats are expected to pursue legislation to strengthen the pre-existing exclusion limitations of the PPACA as well as to intervene in the lawsuit challenging PPACA which was brought by roughly 20 Attorney Generals. However, given they only have control of one chamber of Congress and the President still has ultimate veto power, it is unlikely Democrats will be able to make much progress advancing their causes.
Another area of focus is whether state election results will have an impact on Medicaid expansion. As discussed in prior blogs, Medicaid expansion often has far reaching implications beyond just increased coverage. Four states (Idaho, Montana, Nebraska, and Utah) voted on Medicaid expansion on their ballots while three other states (Kansas, Maine and Wisconsin) had key gubernatorial races that could lead to Medicaid expansion. Following this election there are now 37 states, including Washington DC, who have adopted the PPACA’s Medicaid expansion.
So while the election is over, the future of PPACA and healthcare reform remains uncertain. It appears that in the short term it will be business as usual with employers and health plans required to continue to comply with the law as it exists today while remaining vigilant about regulatory modifications that may change how the law is interpreted. We will continue to follow any changes closely. The one thing that remains clear is that employer need to implement a strategy around their benefit plans focused on providing a competitive package that meets the needs of their employees while fitting within budgetary constraints. Additionally, cost control measures at the plan level should remain a top priority as there are no silver bullets coming from our legislature. If you would like to speak with us about your benefit strategy please contact us.