With Another Critical Court Case Looming, AHPI Governors Briefed on Impact of Failed ACA Replacement Bill

March 31, 2017

Though efforts on Capitol Hill to repeal and replace the Affordable Care Act have stalled, a case pending before the D.C. Circuit Court of Appeals could heighten public attention if the result is to cause insurance companies to exit the ACA exchanges.  In the case—House v. Price—the District Court held the Obama administration was illegally reimbursing insurers for the ACA exchange cost-sharing subsides without Congress explicitly appropriating the money.  Insurance companies must decide over the next three months whether to sign onto the exchanges for 2018 and, in the absence of Congress appropriating funding for the subsidies, economic reality may force them out.  Meanwhile, the American Health Policy Institute Board of Governors held a conference call Wednesday to discuss the implications of the case, the impact of the House of Representatives not holding a vote on the Republican American Health Care Act, and what it all means for CHROs and their teams.  Tevi Troy, CEO of AHPI, explained how the plan fell apart after facing scrutiny from both Freedom Caucus members and moderate Republicans, while getting no support from Democrats.  Marc Reed, AHPI Chair and Chief Administrative Officer at Verizon, stressed that the employer community will continue to actively secure their seat at the table to shape the future of health care reform as Congress and the Administration seek a way forward on the issue.  AHPI Chief Economist Mark Wilson gave an overview of the current legislative state of play, the potential for the D.C. Circuit Court of Appeals to invalidate the funding for the ACA's cost-sharing subsidies on May 22, and what impact this could all have on corporate tax reform this summer.  Wilson also explained how President Trump's executive order and other congressional bills in the pipeline on medical malpractice reform, preserving wellness programs, protecting stop-loss insurance, and enabling association health plans, could provide regulatory relief to employers.  Troy noted that the problems with the ACA and rising health care costs are not going away anytime soon and argued that real pursuit of a value-driven health care system is not going to come from Washington, but it can and must be driven by employers.  As soon as a new path forward becomes clear, enabling the House to vote on ACA reform, the Association will brief the entire membership on the status of reform and our lobbying agenda.