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No matter who is elected president Nov. 8, powerful corporate interests now depend on the Affordable Care Act, which means the law of the land is here to stay, experts said recently.
Pharmaceutical manufacturers and payers have picked up massive new markets through the ACA, said Robert Field, a health policy lecturer at the University of Pennsylvania. The healthcare law is so interwoven across consumers, industry and other public programs that repealing the ACA teeters on the brink of virtual impossibility, Field noted at an annual seminar on health policy hosted by Penn’s Leonard David Institute for Health Economics.
One possibility, however, is an approach whereby Republicans write and pass legislation that is effectively the same as the ACA and simply re-brand it under a new name, says Julie Sochalski, Ph.D., R.N. and professor at Penn’s nursing school.
Still, the panelists agreed that changes to the law are in order. The next administration must address issues such as balancing the marketplace risk pool and exchange product pricing.
The public debate over the exchanges misses the fact that the ACA cannot be judged by the marketplaces alone, as half of new coverage gains were supposed to come through Medicaid expansion, noted David Grande, a professor at the Perelman School of Medicine.
Modifying the ACA to address wasteful healthcare expenditures that don’t benefit patient outcomes is an “incredibly difficult problem,” Grande noted. The next administration, he said, should ensure that new payment models don’t end up encouraging further healthcare industry consolidation that ultimately pushes prices up “even further.”
Meanwhile, party members on both sides of the aisle have pushed for a repeal of the ACA’s Cadillac tax, but have not found common ground on how to replace it, experts said at a recent forum on health policy hosted by the National Coalition on Health Care, according to Bloomberg. Because of that discord, Congress is likely to debate a repeal but probably won't get it passed, Urban Institute’s Robert Reischauer said.