Health Care 2015 – What Lies Ahead
Once the results from the November election cycle were known, pundits around the nation began to speculate about what it all meant for the Affordable Care Act. No matter which political side you fall on, chances are you have a very strong opinion about the law. In Washington, with the Republican Party taking over all of Congress, it is only natural to project what that might mean for the ACA. Let’s take a look at five things that will impact the coming year in health care.
Contrary to the belief that the new Congress will have the greatest impact on changes to the law, the truth is that a lawsuit being argued in March before the Supreme Court is the “must-see”event to watch. The case revolves around the provisions in the ACA that only allows the government to subsidize coverage in states that are running their own exchanges. Since thirty-seven states are relying on Washington to run their exchanges, a Supreme Court ruling in favor of the plaintiff could fatally damage the health care law and the distribution of federal subsidies.
Will the new Congress try to repeal the ACA?
While the Republican Party has won a majority in both houses, they do not have a sufficient majority to push through a full repeal of the health care law. Observers expect to see congressional votes within the first few months of the year to repeal the ACA, but no one expects any of them to be successful.
Instead, insiders are predicting that some of the more unpopular provisions of the law, such as the medical device tax, Medicare control board, and full-time employment provisions will be dealt with through legislation designed to roll back those specific items.
Are there any other options?
As we enter year two of the ACA, millions of Americans now have healthcare where before the law they had none. Even if the Supreme Court rules against the ACA, is it conceivable that the law would simply vanish? Of course not, regardless of what the Supreme Court decides, or what anti-ACA laws are introduced by the new Congress, no one believes that universal health care would be taken away from the millions who are using it.
However, what is apparent is the very real need for a fallback option should the law be struck down. To date, the ACA’s detractors have failed to describe a workable alternative to the law. It seems unlikely that republican governors and state legislators would be in favor of seeing their constituents lose their insurance coverage. The interesting development will be what happens when or if the courts deal a fatal blow to the ACA and how the President and Congress will finally learn to work together on a viable alternative.
The ACA’s impact on our Tax Code
The ACA has had a profound impact on our nation’s health care system. However, it has probably had an even bigger impact on the tax code. The health care law was designed to make premiums affordable for consumers through the use of subsidies. These subsidies are distributed to the consumer as a tax credit. This coming year, how the ACA is impacting our tax system will be front and center for millions of tax paying Americans.
Those that may have ignored the ACA mandate that everyone purchase or have coverage will find that they are being penalized on their taxes. On the other side, those that have received subsidies will have to prove that they deserved to receive a federal subsidy. If they are unable, they will see a portion of their tax return be taken away to cover the difference. In either case, it is a very strong bet that tax preparation companies are going to have a banner year in 2015.
Does the ACA deliver on its promise?
One other thing that will become readily apparent in 2015 is if the ACA is delivering on its promise of health care for the uninsured. In 2014, the estimates were that almost 7 million people got health insurance through an exchange while another 9 – 10 million were moved onto the Medicaid roles for low-income Americans.
With the first year of actual coverage behind us, this year the experts should have access to better data and information to analyze whether or not the law is living up to its promise. It appears that the number of uninsured individuals has decreased significantly; only a deeper dive into the data will tell the true story.