We canvassed some businesses in the midstate about their initial thoughts on the GOP’s replacement of the Affordable Care Act. Here are their thoughts.
Rob Glus, Conrad Siegel Actuaries
Many businesses have long rallied for a more employer-friendly alternative to the Affordable Care Act. The bill proposed by House Republicans this week seems, at least on the surface, to provide just that, said Robert Glus, chair of Susquehanna Township-based Conrad Siegel Actuaries’ health and welfare committee.
The replacement offers a range of potential benefits to companies, most notably the repeal of the ACA’s mandate for large businesses to provide affordable health insurance for employees, Glus said. It also delays – although does not repeal – the ACA’s so-called Cadillac Tax by five years, from 2020 to 2025. That tax will apply a 40 percent levy on businesses for plans that exceed a certain value.
That’s not to say the plans proposed in the replacement bill would necessarily be a win for everyone, Glus said. The bill’s effects on individuals, especially people with lower incomes, could indirectly impact the plans employers are able to offer.
The replacement also does not completely do away with all the employer requirements levied by the ACA. For example, employees’ children can still remain on their parents’ insurance until age 26.
“There are winners and there are losers,” Glus said. “If there’s an underlying concept to this, it’s trying to remove regulatory burden on employers.”
Andy Carter, Hospital and Healthsystem Association of Pennsylvania
“While we do not yet have the official details that outline coverage impacts under this proposal, an initial review of the American Health Care Act raises concerns that it does not fulfill our core principle that any replacement plan must ensure continuity of coverage and care through access to a robust, competitive delivery system.
“The significant Medicaid changes contained in the plan will negatively impact expansion states like Pennsylvania, and ultimately jeopardize coverage for the 700,000 people who have benefited from the ability to access care, as well as others who are eligible for Medicaid coverage.
“In addition, the plan threatens the progress hospitals have made to improve health care, as the stable and sufficient resources needed to support providers in maintaining access to care is jeopardized.”
Carter said key concerns include restructuring Medicaid, phasing out coverage offered as a result of expansion, the sufficiency of new policies to support coverage including tax credits and threats to hospital funding.
“The financial burden that is seemingly being shifted to low-income individuals, many of whom are working, jeopardizes the important progress we have made to provide these individuals with the right care, in the right place, in the right time. Advanceable, refundable tax credits are superior to tax deductions to meet the needs of this population, but the amounts contemplated do not sufficiently match the support currently provided.
“HAP remains steadfast in our position that the progress that has been made to benefit 1.1 million Pennsylvanians through expanded coverage should not be threatened. We will continue to analyze the proposal to better understand the impact of this legislation on Pennsylvania residents and providers.”
Eric Beittel, Enders Insurance
“Obviously insurance brokers will want to study the Republican alternative to the Affordable Care Act to examine what effect it will have on individuals and businesses but some preliminary observations can be made,” said Eric Beittel, a financial planner and insurance provider at Lower Paxton Township-based Enders Insurance Associates.
Beittel also serves as the legislative chair for the Central Pennsylvania Association of Health Underwriters.
“First, some parts of the ACA that have an unanticipated consequence of increasing costs would be eliminated. The federal premium tax on health insurers, the federal excise tax on gross revenues of the medical device manufacturers, delay of the so-called Cadillac Tax until 2025 all mean increased final costs paid by those with private sector health insurance. Other sections help consumers with health savings accounts by removing the ACA ban on over-the-counter purchases as being medically eligible for HSAs.
“Second, the lead-in to repeal of the premium tax subsidies for those in exchanges to 2020 is positive in that those enrolled in exchanges will have some time to adjust. The repeal, besides saving taxpayer dollars on premium subsidies, will remove the fig leaf where the costs were hidden by the subsidy. Now, the spotlight will be squarely on health care cost drivers such as the need for tort reform.
“Third, the important role of the licensed insurance agent or broker is shown because people will need some expert advice as they make the transition to the post-ACA world. The U.S. had a functioning system where licensed agents and brokers directly helped people better understand how they can make better health insurance choices. Under Obamacare, the private sector individual insurance market has virtually collapsed, in part due to government’s belief that an impersonal healthcare.gov or unlicensed navigators was better than utilizing the real-life skills of local state-licensed insurance professionals.”
Gov. Tom Wolf
Gov. Tom Wolf the GOP plan would “roll back years of progress that drastically reduced Pennsylvania’s uninsured rate and expanded coverage options for seniors, the disabled and those seeking treatment for a substance use disorder.
“This plan does not fix the Affordable Care Act — it would just delay the Republican plan to cut coverage for nearly a million Pennsylvanians, including those who were able to access quality, affordable health care after I expanded Medicaid two years ago.
“It will eliminate health care coverage for middle class families while encouraging insurance companies to increase executive salaries. This is a bad plan that would leave thousands of Pennsylvania seniors and families unable to afford access to basic medical care coverage.
“As I have repeatedly said, any plan that cuts Medicaid or reduces options for affordable, quality health insurance for Pennsylvanians is unacceptable. I strongly encourage everyone in the Pennsylvania delegation to reject this proposal.”
“We believe that our customers, and everyone in Pennsylvania, are best served by a competitive, stable and private health insurance market that offers a variety of choices at reasonable prices,” said spokeswoman Kirsten Page. “We have just begun to review the most recent proposal in Congress and look forward to working with all policymakers as changes are considered.”