The Future of the Affordable Care Act

Welcome back! When we last met, we talked about the history of the Affordable Care Act. And with the tumultuous present it’s experiencing, we figured we’d take a moment to discuss the future of the Act.

As you may be aware, President Trump’s first executive order, signed the Friday he was inaugurated, targeted the ACA, giving federal agencies broad leeway to chip away at the Act’s requirements. His one-page directive gives agencies the authority to grant waivers, exemptions, and delays of provisions in ACA compliance.

The full impact on Americans and their health insurance, however, won’t become apparent until federal agencies respond to these waivers and exemptions. You can read the full text of the order here. But for some answers to the more common questions about it, keep reading here.

What does Trump’s executive order do?
Basically, Trump’s order states that federal agencies can grant waivers, exemptions, and delays of ACA provisions that impose costs on states or individuals. This appears to be so that one of the law’s most unpopular requirements – that individuals have health insurance or pay a fine – is undone while Congress decides the ultimate fate of the ACA (more on that later).

The order doesn’t give us much to go on with regards to whether the IRS will waive fines for those failing to secure coverage since the order’s issue. Additionally, the White House hasn’t explained how it wants the agencies to respond. It does, however, direct agencies to stop issuing regulations that would expand the Act’s reach. Additionally, the federal government must allow states greater flexibility in carrying out health care programs.

Will those who have insurance under the ACA lose coverage as a result of this order?
Since the order doesn’t directly target the insurance marketplace, various experts have said that it could lead to broad exemptions from the law’s coverage requirement which could scare off insurers.

You see, insurers currently see the coverage requirement as a tool to nudge healthy people into buying coverage. Without this requirement, companies and most independent experts believe premiums would spike, effectively making’s insurance markets unsustainable.

How quickly will any changes take effect?
New regulations cannot be issued overnight, and this executive order may not have much of an impact in 2017. Government rules for this year have already been incorporated into insurance contracts, and departments like the Health and Human Services and the Treasury would have to issue policies that embody the order’s outline.

What is Congress’s plan for the ACA?
Republicans fought hard to keep the ACA from even passing, so with control of both the White House and Congress, it’s evident that undoing the Act is at the top of the party’s agenda this year. While it’s generally agreed that the Act will be repealed by Congress, their replacement for the law is far less certain.

Ideally – and according to Trump, shortly before he took office – Congress will pass the repeal and replace measures “essential simultaneously.” Ambiguity still surrounds what exactly will be included in a replacement package, but Trump has said his administration will have a plan once the Senate confirms Rep. Tom Price, his nominee for the Department of Health and Human Services. For now, we can only speculate what this replacement package will include.

As for ACAwise…
So long as the Affordable Care Act is still in play, so are we! While the future of the ACA may be uncertain, we’re still here, still e-filing ACA Forms for the 2015 and 2016 tax years. To get started, just sign up over at!

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