The Fate of the Affordable Care Act

The dawn of a new healthcare landscape is upon us. But what exactly it may look like when the dust of the new Trump Administration settles is anyone’s guess.

We know a few things courtesy of President Trump’s executive order calling for the “prompt repeal of the Patient Protection and Affordable Care Act.” But that order provided little specifics about the fate of many of the hallmark features of the law — and with that, the complex federal rules and regulations that govern it.

That includes whether young adults can remain on their parents’ policies, if the pre-existing condition provision will be diminished or outright repealed, and whether Medicaid expansion is contracted. After the election, Trump signaled that the pre-existing condition provision should remain intact. However, it is unclear whether that sentiment squares with Republican promises to fully dismantle the law.

For now, it seems leaks in the media and the Sunday morning talk show rounds will be our best sources of public information, as well as assessments from think tanks and non-government sources like the Kaiser Family Foundation. For instance, on Sunday, Reuters reported that the administration may not enforce the individual mandate. And in recent televised interviews, administration officials and Republicans in Congress have promised that no one would lose their Obamacare coverage until new laws are enacted. But it’s challenging to make critical decisions on “mays” and “promises.”

It may be weeks, or months, until we have a clear idea — and a concrete set of proposals that we can act on — regarding the future of ACA, as well as the federal government’s role in the healthcare industry. For the moment, we’ll need to turn to soundbites, news leaks, and other sources to guide us.

Ultimately, similar to the sweeping changes we needed to respond to for ACA, we will likely need to drastically respond and pivot yet again — perhaps far greater than ACA. The new administration and the Republican-led Congress is intent on conducting a far-reaching overhaul of ACA, yet the degree to which that will play out is relatively unknown. No doubt, thousands of pages of new policy will be phased in, while thousands of pages of old policy will be tossed out the door.

Our challenge will be to follow prior rules, laws, and policies, while adapting to the new — having our feet, in a sense, in two ponds with the waters ever-shifting.


For additional information, check out our ACA white paper: Potential for Change and Subsequent Impacts of the ACA.