ACA Expectations Heading into the 2020 Election
3 minute read:
As the fourth quarter of 2020 draws near, so does the presidential election. A popular topic of debate to be addressed in the coming election is healthcare, and the ACA in particular.
This election, much is at stake for Americans, and while it’s true that since the COVID-19 pandemic hit the U.S. in March, voters’ priorities have shifted away from healthcare as the top concern to be addressed in the election, it will still be an important determinant for voters come November.
A recent report from the Kaiser Family Foundation (KFF) shows that 10% of voters believe that healthcare is the top issue for the 2020 presidential election. The majority of voters now believe that concerns regarding the economy, the coronavirus, race, and policing are the most important issues. Nevertheless, healthcare still makes the top five. So where do the candidates differ in terms of healthcare policy? A good way of differentiating the two can be seen by recapping what Trump has done in the last four years.
When Trump first took office in 2016, he touted a top priority: dismantling the Affordable Care Act. During his four years of presidency, he removed the penalty associated with the Individual Mandate, modified the use of Health Reimbursement Arrangements (HRAs), and introduced short-term association health plans, among other actions.
Perhaps the biggest threat to the ACA during Trump’s presidency is California v. Texas, the Texas court case claiming that the entirety of the Affordable Care Act is unconstitutional without the Individual Mandate. The current status of this case is uncertain; it is currently scheduled for oral argument before the Supreme Court on November 10, 2020 – just after the election. It is doubly unclear how the recent death of Justice Ruth Bader Ginsburg and the gathering political fight over filling her seat will affect this litigation. Without a doubt, if this case is successful, it will have a devastating effect on health care in the U.S., a nation already reeling from the COVID-19 pandemic. According to the Kaiser Family Foundation: “A host of ACA provisions could be eliminated, including protections for people with pre-existing conditions, subsidies to make individual health insurance more affordable, expanded eligibility for Medicaid, coverage of young adults up to age 26 under their parents’ insurance policies, coverage of preventive care with no patient cost-sharing, closing of the doughnut hole under Medicare’s drug benefit, and a series of tax increases to fund these initiatives.” Nonetheless, the Affordable Care Act has demonstrated its lasting import within the American legal landscape time and time again, including, notably, in the case King v. Burwell, in which the Supreme Court upheld the ACA’s constitutionality.
Despite the Trump administration’s efforts to remove the law, several states have passed their own legislation to defend the law, enacting measures from state-wide individual mandates to special enrollments and expanding Medicaid. For every change the ACA has endured, there has been a governing body to reinstate it to some degree. And so, even if Trump wins the election, the ACA is likely to remain for quite some time.
The presidential candidate Joe Biden has a profoundly different stance on healthcare and the ACA. The former Obama-era vice president was present for the signing of the ACA into law in 2010, and is in full support of the strengthening of many provisions of the ACA.
According to Biden’s official page, “He opposes every effort to get rid of this historic law – including efforts by Republicans, and efforts by Democrats. Instead of starting from scratch and getting rid of private insurance, he has a plan to build on the Affordable Care Act by giving Americans more choice, reducing health care costs, and making our health care system less complex to navigate.” If Trump wins the election, the ACA will continue to face challenges, although it is unlikely to be removed altogether. If Biden wins, the ACA will continue to be expanded upon.
Employers, for the foreseeable future and with Biden leading in the polls, the ACA is almost certain to remain a part of our healthcare ecosystem, and that means continuing to comply with the law’s Employer Mandate. Under the ACA’s Employer Mandate, Applicable Large Employers (ALEs), organizations with 50 or more full-time employees and full-time-equivalent employees, are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is affordable for the employee, or be subject to Internal Revenue Code (IRC) Section 4980H penalties.
Organizations that would benefit from ACA compliance assistance should contact us to learn about ACA Complete, as the IRS is increasingly issuing penalty assessments to employers that have failed to comply with the healthcare law.
To learn more about ACA compliance in 2020, click here.
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