If midterm elections lead to a Republican-led House, it could mean some change to healthcare reform. Yet employers can be certain that some aspects of PPACA will affect them no matter what.
By KATIE KUEHNER-HEBERT, a freelance writer based in San Diego with more than two decades of journalism experience and expertise in financial writing
A Republican victory for control of the U.S. House of Representatives in the midterm elections on November 2 could lead to the gutting of some aspects of federal healthcare reform, experts say. Yet no matter what, employee benefits managers will likely continue their push to have employees share more of the cost.
"A change in control of the House could bring an element of uncertainty into the marketplace," said Richard Zall, chairman of the healthcare industry practice group at law firm Proskauer Rose LLP.The change might cause some of the more cautious benefits managers at U.S. employers to hold off revamping their plans to comply with the Obama administration's Patient Protection and Affordable Care Act (PPACA) in case Republicans can either block funding or stymie implementation in other ways.
Henry Aaron, senior fellow and healthcare expert at the Brookings Institution, said that, if the GOP were to gain a majority in either body, they could bar the Department of Health and Human Services (HHS) from writing the necessary regulations to implement the new law. Republican lawmakers could also bar appropriations of the necessary funds.
While the legislation has already appropriated $1 billion to the HSS, it could cost up to $10 billion to implement the new law, Aaron said. Opponents, for example, could block funding for the Internal Revenue Service to collect the information needed to compute subsidies and pay them.
"What would be left is 'zombie' legislation," Aaron said. "Administrative agencies will not be able to put it into effect, or to make it function efficiently."
Paul Howard, senior fellow and director of the center for medical progress at the Manhattan Institute for Policy Research, agreed that opponents of the new law could bar funding if the Republicans gain control.
GOP leadership could call for oversight hearings on subsequent impacts of the bill's passage, such as the pricing of policies, access to insurance and incidents where companies dropped coverage altogether.
However, Howard also believes that there could actually be opportunities for bipartisan fixes to the new law to mitigate further stresses on the federal deficit--even President Obama has said that "everything has to be on the table," including the healthcare law.
"We don't want a fiscal crisis like that of Greece, France and now Britain, so if we get our house in order now, any future cuts can be more moderate," Howard said.
Congress could also look at reducing the income ceiling level it takes to receive subsidies, now at 400 percent of federal poverty level, and at enacting more targeted subsidies, such as those for people with pre-existing conditions who are uninsured by their employers. Congress could also create a stable fund for high-risk pools, as many state funds have run out of money, as well as create tax credits.
EMPLOYERS STALL FOR INEVITABLE?
Zall said that some companies might decide to freeze plans for amending their benefits until there is more clarity on actual implementation of federal healthcare reform.
Yet even if Congress is split, some parts of the healthcare bill will not change.
"For example, insurers can't turn down people with pre-existing conditions, the insurer can't rescind a policy when somebody gets sick, and dependents are covered through the age 26," said Zall. "Most consumers and company execs would say those are good things."
Moreover, the states will likely proceed with the insurance exchanges--one of the aspects of healthcare reform that has been largely bipartisan.
"I don't see any groundswell to eliminate exchanges," Zall said.
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