Many people are fearful of the regulations and guidelines issued by the Trump administration that undermine some of the ACA’s programs, whereas others say that it has continued by and large, to enforce the law as written.
Many people feel that it is of utmost importance that Congress take action to consolidate coverage gains made under the ACA because if administration policies continue to undermine insurance markets, previous gains that were fought long and hard for, may soon erode.
President Trump and the ACA
The president was elected promising to repeal the ACA and on his first day, he demonstrated this by issuing an executive order intended to turn back ACA implementation. From his Tweets, to press statements, to comments made in interviews, he has continued to attack the law from day one. Many people feel that his actions mirror his words and that he is in fact, trying to sabotage enforcement of the law.
For the first time ever, a president is being sued in a lawsuit claiming that the president is violating his constitutional duty to “take care that the laws be faithfully executed.” While the litigants in this case and many others find that there is a great deal of truth to this charge, others point out that it does not capture the complexity of the Trump administration’s approach to the ACA, particularly in regard to the reforms that the ACA made to the individual market. Proponents of the administration’s handling of the ACA point out that while it has undermined certain individual market programs, reduced or eliminated the federal role in administering others, and created an alternative individual health insurance market independent of the ACA, it has in fact continued to implement other ACA programs that stabilize and support the individual market.
Where is the Current Administration Heading with the ACA?
While the previous information is a broad generalization of everything that has been going on with the current administration’s changes to the healthcare of Americans, it has hopefully provided you with the basics for what is currently going on. Many additional factors indicate that the administration is uncomfortable with its responsibility to enforce and administer the ACA. In litigation brought by Texas and other Republican-led states, the Department of Justice has taken the position that the ACA’s individual mandate is unconstitutional and that its ban on preexisting condition exclusions, and its guaranteed issue and community rating requirements, should be invalidated. The outcome of this litigation has yet to be determined at the writing of this synopsis.
At this point, the ACA remains largely in place while the cost of coverage in the individual market for people who lack subsidies has grown significantly. This is due in large part to the instability created by administration and congressional repeal efforts. Marketplace premiums and insurer margins are stabilizing and new insurers are entering new markets. There has been a significant decrease in the unsubsidized enrollment in the individual market but enrollment in the subsidized market has only contracted marginally. Indicators point to the availability of premium tax credits as being a stabilizing force that has offset the shocks the individual market continues to absorb.
Many people fear that if Congress fails to take action to consolidate the gains that the ACA achieved and has continued to maintain throughout the current administration, and if administration policies continue to undermine insurance markets, these gains may begin to dissipate and possibly, disappear.
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