Possible ACA Outcomes If Joe Biden Is Elected in November

2 minute read: With the 2020 presidential election a few short weeks out, it’s incredibly important that voters understand what Joe Biden versus Donald Trump will do to the ACA if elected. As previously covered in the ACA Times, it is expected that the Trump Administration will continue to undermine the ACA while Biden would work to strengthen the law and build upon it. The question, however, is how will Biden build upon the ACA if elected? There are a number of possibilities that could ensue. Some of the probable outcomes that could affect the ACA as a result of Biden winning the 2020 election include the following: First and foremost, if Biden won the election, the California v. Texas court case that asserts that the Affordable Care Act is unconstitutional without the Individual Mandate would face significant challenges moving forward. A Biden administration would at the very least present compelling arguments in support of the ACA. It is possible that he would reinstate the federal Individual Mandate penalty, a move that would be largely supported, as many states have passed their own version of the law since the federal mandate was zeroed out. The other possibility is that the administration would reiterate that the Individual Mandate is indeed severable from the remainder of the law and can continue on without it. While the decision will ultimately fall into the hands of the Supreme Court, it is uncertain how the courts will rule. Oral arguments are to be held the week following the election and a decision is likely to be made in 2021. With Biden at the helm, however, the ACA will face significantly better odds. Another area of the ACA that could change if Biden wins can be found in the Association of Health Plans. The Department of Labor states that “Association Health Plans are group health plans that employer groups and associations offer to provide health coverage for employees.” The Trump administration made adjustments to the rules of these types of plans and essentially lessened the requirements for employers forming these types of associations. However, a consequent problem was that this made it easier for organizations to offer less than comprehensive health coverage to employees and exempt employers from the ACA’s small-group health insurance rules. If Biden is elected, we can anticipate a roll-back on the association health plan rules or even a complete withdrawal from the plans altogether. An area in which Biden could be especially successful in bolstering the ACA can be found in the expansion of Medicaid. With two states having expanded Medicaid under the ACA during the COVID-19 pandemic and the creation of a new group of persons eligible for Medicaid assistance, the program has more than proved its value. According to a post by Politico, “Biden is resolved to extend coverage to millions of poor adults who have been shut out of Medicaid expansion in the dozen states that have refused the program. His public option plan would automatically provide zero-premium coverage to poor adults in those Medicaid expansion holdout states.” An area that may not see much change if Biden is elected is the ACA’s Employer Mandate. As a reminder to employers in conjunction with the Employer Shared Responsibility Payment (ESRP), 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. Employers that need assistance in complying with the ACA’s Employer Mandate are encouraged to contact us to learn how ACA Complete can satisfy these requirements of the healthcare law. With the IRS issuing Letter 226J penalty notices for the 2018 tax year, and filing season for 2020 right around the corner, now is the time to ensure your ACA compliance processes are in order.

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