The passage of the Patient Protection and Affordable Care Act (ACA) has changed the landscape of healthcare for all players involved in health care. This landmark legislation has broad implications for patients, providers and insurance companies.
The ACA expands access to health insurance to millions of consumers via health insurance exchanges and sets forth many new regulations for new and existing private insurance plans. For example, health insurance companies can no longer refuse to cover or charge consumers more for having a pre-existing conditions and consumers are guaranteed the ability to obtain preventive care through their health insurance plans. The law mandates that virtually all Americans have health insurance in some form and that large businesses offer health insurance to its employees. The health insurance marketplace has created an array of new and different networks for consumers to choose from.
Despite these improvements in the health insurance marketplace, many challenges remain. So-called skinny networks, high individual and family deductibles and co-pays making “insurance” less affordable and widespread mergers and acquisitions the ACA has spawned and what this means for access to health care are just some of the challenges that remain.
In addition to the existing policy challenges, the ACA is facing significant political headwinds. The 2016 election resulted in Republicans gaining control of the White House in addition to both Chambers of Congress - allowing Republicans their best opportunity to date to repeal the ACA and replace it with their own alternative. This effort has been broken down into three phases: budget reconciliation, regulations and traditional legislation.
Our staff understands the complexities of this legislation and the rule making for implementing its provision. We use our expertise to identify and guide our clients through each relevant provision of the bill. CAI staff routinely gives presentations on the ACA, the Republican alternative and how they impact an association or industry.