How Will the Election Affect Health Care Reform?

Compensation Administration
by Stephen Bruce, PhD, PHR
"Here’s the third in our popular series of “Eye on the Election” posts which are focused on helping employers prepare for post-election changes, no matter who is elected."

Eye on the Election

For today’s topic—likely changes to health care reform after the election—we turned to BLR legal editor Jessica Webb-Ayer, J.D., editor of the Benefits Compliance Advisor online newsletter and the benefits manual Benefits Compliance: Strategies for Plans, Programs & Policies.

Although health care reform (also known as the Affordable Care Act or ACA) overcame a large hurdle when the U.S. Supreme Court upheld its provisions this summer, it still remains a major issue in the upcoming November elections. How could the presidential candidates’ positions and the national election results affect health care reform and therefore employers?


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The Candidates’ Positions

President Barack Obama’s position is pretty easy to figure out—he stands by the ACA that he signed into law on March 23, 2010. In fact, his campaign website states that:

Obamacare is making health care work better for all of us, even if you already have insurance. It puts the health of your family first—ensuring access to free preventive care and protecting consumers from insurance company abuses.

Mitt Romney has embraced a “repeal and replace” strategy, although he has indicated that he would keep some of the more popular ACA provisions in some form. His campaign website provides the following details about his plan:

On his first day in office, Mitt Romney will issue an executive order that paves the way for the federal government to issue Obamacare waivers to all fifty states. He will then work with Congress to repeal the full legislation as quickly as possible.

In place of Obamacare, Mitt will pursue policies that give each state the power to craft a health care reform plan that is best for its own citizens. The federal government’s role will be to help markets work by creating a level playing field for competition.

Election Outcome Scenarios

Although a lot of the media focus has been on what the presidential candidates’ plans are for health care reform, the makeup of the U.S. Congress is also vital to what happens with the law. So let’s take a look at several different scenarios and what they might mean for the ACA.

If Obama Wins

If Obama wins, the status quo will most likely prevail. His administration would continue to implement the ACA and may even become more aggressive in carrying out the law’s provisions. Many election commentators think that the administration will quickly issue more regulations implementing the law and that the insurance exchanges will also move forward, with the federal government setting up exchanges in states that decide not to establish one themselves. 

If Romney Wins

A Romney win doesn’t necessarily mean that the ACA is gone. For one thing, as discussed above, he has indicated that he wouldn’t get rid of all of the law’s provisions. However, there could be delays in implementing the law, and depending upon the makeup of Congress, there could be a lot of gridlock in Washington.

Romney, a Democratic Senate, and a Republican House. If the election swings this way, it would be difficult to get rid of the ACA through legislation because although the House would most likely continue to pass legislation repealing the law, it wouldn’t get past the Senate.

However, Romney would have an advantage because he would control the agencies that issue the regulations. His administration could write new regulations and/or delay or stop regulations that are set to come out. Also, many analysts predict that a Romney administration would approach the health insurance exchanges in very different ways.

Romney, a Republican Senate, and a Republican House. In this situation, Romney could accomplish his campaign goal and repeal or modify a lot of the ACA. However, although Republicans would probably definitely try to get rid of unpopular provisions such as the individual mandate, they might attempt to leave certain popular consumer protection provisions in place. Additionally, the administration and Congress would probably make a lot of changes to the exchange guidelines.

Takeaways for Now

Although we don’t know what results the election will bring, the benefits world will continue to be affected by health care reform. Employers must remain in compliance with the provisions already in place and continue to strategically plan for and implement the provisions set to go into effect in the future. They must also be ready and watching for new health care insurance reform-related regulations and guidance.

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