For the first time in more than a decade, Republican frontrunners eyeing the 2024 election aren’t campaigning for the elimination of the ACA.
It’s a rather big shift from previous election focal points too, considering that ever since the ACA first passed in 2010 it’s been in the crosshairs of every leading GOP presidential candidate. Having reached the Supreme Court regarding constitutionality more than once, to say the ACA has faced scrutiny would be an understatement.
While it’s true the now 13-year-old healthcare law has received many amendments, for the first time in its history, it feels more stable than ever.
And that “feeling” is one grounded in concrete evidence. In fact, according to a recent poll by Gallup, nearly 60% of Americans believe healthcare coverage should be a federal government responsibility—something the ACA first required.
But why exactly aren’t we hearing about “repeal and replace” as we have so many times before? In this post, we’ll take a closer look at the healthcare landscape and explore why the ACA, and healthcare policy as a whole, have escaped as a topic of debate heading into the 2024 election.
Why Aren’t Republicans Campaigning for an ACA Repeal?
It’s uncanny that we haven’t heard Trump, DeSantis, Christie, and others discuss the ACA during recent debates. Upon closer inspection though, it’s wise that they’ve focused their arguments elsewhere.
As for the reasons why the ACA feels more ingrained in U.S. healthcare than ever before, there are many.
The first is that ACA marketplaces are experiencing their highest level of participation. The 2023 open enrollment saw over 16 million Americans obtain coverage through either a state or federal marketplace. With the 2024 open enrollment now underway, it’s presumed to see yet another successful turnout too. In short, ACA coverage through government exchanges is thriving.
Beyond participation in the federal and state-run health exchanges, the ACA has formed a patchwork quilt of regulations across the U.S., with many states having introduced new laws to uphold the requirements of the ACA.
California, Rhode Island, New Jersey, Massachusetts, and Washington D.C., for example, enacted state-wide mandates requiring residents to obtain coverage or face a penalty. These mandates were introduced to combat Trump’s zeroing out of the federal Individual Mandate in 2019 and have changed the landscape for ACA compliance.
Several other states have codified portions of the ACA into their legal code, further complicating the healthcare landscape. Michigan most recently amended its regulations to ensure that health carriers offer coverage regardless of any preexisting conditions—a protection first instituted by the ACA.
These developments underscore the significance of the ACA’s role in U.S. healthcare. As states continue to adopt new portions of the ACA, it paints a clear picture to opposing politicians that there is real value in the ACA—so much so that state and local governments are taking measures to preserve key benefits.
A Bedrock of U.S. Healthcare
With a series of various ACA regulations now entrenched into various state frameworks, it would seem certain that the ACA is here to stay—but the evidence doesn’t stop there.
The ACA’s significance was mostly recently spotlighted during the greatest health crisis of our time—the COVID-19 pandemic. Many of the ACA’s provisions, including preventive care services, ensured that benefits like COVID-19 vaccinations were free and available to all.
The rollout of special enrollment periods also ensured that Americans were able to obtain coverage during the pandemic.
With this information widely available, it would be risky for Republican presidential candidates to promote an ACA repeal in their 2024 election campaign. At this point, it’s become evident that the law is an important component of U.S. healthcare.
Unchanged ACA Provisions
Now that GOP presidential candidates have tossed out the “repeal and replace” script, it appears the future of the ACA is brighter than ever. And organizations that have forgone their ACA Employer Mandate responsibilities in hopes the law would be thrown out should reassess their position.
As made evident in the latest round of Republican debates, the ACA is not going anywhere and compliance with the Employer Shared Responsibility Provisions is more critical than ever.
For those who don’t recall the regulations, the ACA’s Employer Mandate requires Applicable to Large Employers, or those with at least 50 full-time and full-time equivalent employees, to offer affordable Minimum Essential Coverage that also meets Minimum Value.
Failing to meet both of these requirements can result in significant penalties from the IRS, such as Letter 226J. The agency is currently issuing these non-compliance letters for the 2021 tax year, though previous years are fair game since there is no statute of limitations.
If you need assistance meeting the Employer Mandate’s requirements, including federal and state reporting, employee furnishing, monthly compliance, establishing affordability, and documenting an audit trail in the event of an IRS inquiry, contact Trusaic. With nearly a decade of experience helping organizations comply with the ACA’s Employer Mandate, we can ensure your processes are audit-proof.
For more information on the requirements of the Employer Shared Responsibility Provisions, download the 2023 ACA Essential Guide for Employers below.
