After Tuesday, everyone is wondering what will happen to Obamacare.
The Affordable Care Act was first and foremost about insurance reform. We’re not going back to a time when health insurers can impose pre-existing conditions limitations. Trump said as much just days after the election.
What about other cornerstones of The ACA.
The employer mandate? Probably here to stay. Maybe the compliance threshold will be raised from 50 to 100 employees. (Would that the definition of “small group” also be raised to 100.) Expect a repeal of the Cadillac tax.
The individual mandate? Probably here to stay. But the absence of risk sharing mechanisms and a move toward community rating have contributed to an inability to bring younger people into the pool. There are easy fixes for that.
Premium tax credits? Why would Republicans kill an idea they were first to propose?
Payment reform. The key to making health care “affordable” is to realign incentives. Now, health systems are paid more for doing more. The big opportunity for the new administration might be the creation of a transparent pricing model based off new Medicare bundled fee schedules.
Upgrades might be legislated one at a time with relative speed.
Probably (that word again) wishful thinking!