Local experts say sit tight on Affordable Care Act

BY CHUCK VANDENBERG

PCC EDITOR

FORT MADISON - With President-elect Donald Trump's inauguration less than two weeks away and the Affordable Care Act squarely in the cross-hairs of the Republican-controlled Congress and White House, local health care experts say knee-jerk reactions are dangerous and to sit tight.

Justin Pieper, co-founder of Group Benefit Partners in Fort Madison, said people who currently have health insurance through the market place should stay the course...and stay informed.

"We hear noise coming from a lot of different directions," Pieper said. "It will be very interesting to see how it all plays out."

Pieper, who returned last week from a seminar on the topic of the Affordable Care Act, said industry experts were told that Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexanderis was on record as saying it could take years to get a suitable replacement in place. With the volatility of the recent general election and another election in two years if things take too long and Americans are get nervy with the current political landscape things could change.

In the 2018 general election, all 435 seats in the U.S. House of Representatives, 33 of the 100 seats in the U.S. Senate and 39 governorships will be contested.

But the environment is more than ripe for quick, sweeping change.

"On the flip side, we have the house and senate that passed legislation through in November that would have completely repealed the ACA and that made it to President Obama's desk. He vetoed it, which everyone knew he would," Pieper said.

"The climate exists where that could happen again, however unlikely, but now we have a willing president. Will the members of Congress act the same way they did before? The speculation is likely not."

He said it would be difficult to separate the parts of the program that most Americans like, such as no pre-existing conditions, to stay in place, while allowing other areas like mandatory coverage to be removed. The no pre-existing condition law was a black-eye to the insurance industry.

"The law completely abolished pre-exising conditions. But the law also said if were going to abolish pre-existing conditions then we needed to offset the huge costs insurance companies incurred by inheriting those claims. We needed to put things in place that gives all individuals coverage so now there's a mandate that very citizen has to have insurance or be subject to tax penalty," he said.

"No human being likely would say we're gonna put those existing conditions back in place, but if we don't have a mandate on the insurance, it's going to be very difficult to make one go away and keep the other. So that's going to need some hard consideration as to how that sorts it self out. Many out there lobby for state-based high risk pools, but something will have to happen if the mandates go away."

The continued emergence of health savings accounts has helped many with some pre-tax benefits to help supplement the high-deductibles incurred by some in their employer or market based plans. Pieper said also having more transparency in the costs of procedures would help consumers as well."

"For a long time our whole country has agreed to medical procedures without knowing what it costs. This will allow individuals to make proper purchasing decisions and find where to have procedures done. And it will also help create a more uniform pricing structure across the country."

"The good new is for any one concerned about a knee-jerk reaction, the political process is in place. The bills have to be created through the House and the Senate and through the standard process. The president can't say this is going to happen. One thing the president can do is suspend enforcement. He can say some of the laws and regulations such as the individual mandate he can choose to direct regulators to not enforce certain aspects. But that will not effect budget items. Those subsidies are budget items and they have to be passed through Congress. So we don't have to be to worried about that."

But he said people should maintain their insurance programs and make sure they have coverage, because all the current laws are still in effect and there are tax penalties if you don't carry insurance.

"Once the President's there and gives suggestions to the Republican legislature, we want to be paying close attention to that commentary. Now we know that the Republican party is playing for real. They weren't playing for real when they sent those previous bills on ACA through. They did what they knew they could. That's really not playing for real, but now they will be able to play for real."

Peiper is co-founder of Group Benefit Partners, who formed the business in 2009 with Jerry Koering and can be reached at866-496-3102.

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