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ACA opponents plan to wait out Obama's term

2016 election results may prompt next move


When Congress gave final approval this month to legislation repealing key provisions of the health care reform law, it was the first time lawmakers had done so since the Patient Protection and Affordable Care Act was passed in 2010.

But that effort, which was immediately vetoed by President Barack Obama, may be the last time Congress votes to repeal ACA provisions until 2017, when a new president takes office, key lawmakers and others say.

While predicting that the ACA will eventually be repealed, House Speaker Paul Ryan, R-Wis., said that isn't likely to occur until after the 2016 congressional and presidential elections.

“We will see this law either collapse under its own weight, or we will see this law, in the next session of Congress, as we are proving here today, be repealed and signed and replaced by a Republican president,” Rep. Ryan said as he signed the legislation earlier this month — vetoed the next day by President Obama — to repeal the ACA's 40% excise tax on costly group health plan premiums, as well as provisions imposing stiff financial penalties on employers that don't offer coverage and employees who don't enroll in a plan.

Benefits experts also place low odds on Congress making major ACA changes this year.

“I don't anticipate any major ACA legislative changes in 2016,” said Geoff Manville, a principal with Mercer L.L.C. in Washington.“There just isn't enough time. It is a very compressed legislative window,” Mr. Manville added.

Because of the upcoming Republican and Democratic national conventions and the fall presidential and congressional elections, the congressional session could end as soon as late June, observers say.

At the same time, action Congress took last year — delaying by two years to 2020 the effective date of the 40% excise tax on the portion of group health care plan premiums that exceed $10,200 for single coverage and $27,500 for family coverage — reduces the need for quick congressional action to address the excise tax, an ACA provision that has triggered widespread employer and union opposition.

“There is not the same sense of urgency given the delay in the effective date” of the excise tax, said Gretchen Young, senior vice president of health policy at the ERISA Industry Committee in Washington.

“The delay in the excise tax more likely pushes the issue to 2017,” said Steve Wojcik, vice president of public policy at the National Business Group on Health in Washington.

Still, the outcome of the November elections could determine the likelihood of congressional action on the ACA, some say.

If a Democrat wins the presidency and Democrats regain control of the Senate, for example, there could be increased Republican interest in making changes, such as repeal of the excise tax, during the lame-duck session likely to follow the elections.

In that case, “there could be more interest in making changes before the president leaves office,” said James Klein, president of the American Benefits Council in Washington.

In addition, some say, the delay in the effective date of the excise tax could delay the release of widely anticipated IRS excise tax regulations.

The delay “gives the IRS the option of taking more time to work on the proposed rules,” Mr. Wojcik said.

Still, the IRS has not signaled that it will do so, with the rules widely expected to be proposed this spring.

“We have not heard anything yet from the IRS about changes” in the timing of the proposed excise tax regulations, said Amy Bergner, a managing director with PricewaterhouseCoopers L.L.P. in Washington.

Since the passage of the ACA in 2010, Congress has approved and President Obama has signed legislation repealing several provisions.

The most recent legislative change was last year when, as part of a broader bill, lawmakers voted to repeal a provision, which had not been implemented, requiring employers with at least 200 employees to automatically enroll employees who did not respond when asked to select a group plan offered by their employers.