Health Experts Consider a Post-ACA World

With the election of President Donald Trump, no domestic policy is a bigger target for change than the Affordable Care Act (ACA), former President Obama's signature health insurance law. His very first executive order, signed within hours of being inaugurated, was aimed at rolling back parts of the ACA. But how, exactly, is the law likely to change, and how will this fundamental policy shift affect the U.S. health care and health insurance systems? Those questions were explored by a panel of health and policy experts at the Employee Benefit Research Institute's 79th policy forum held in Washington, DC, last December, attended by more than one hundred people. The short answer, as the new administration was taking shape: Nobody knows. But whether it's a “repeal and replace,” as many congressional Republicans have advocated ever since the law was enacted in 2010, or “repeal and delay” or “partial repeal” or “repair” (as some are now suggesting) or just “repeal,” it seems certain that change is on the way. Some observers say there could be seismic effects on the financing and even the structure of health care and health insurance in America -- and consequently on patients and health-care providers -- depending on how quickly and how sweeping those changes are. Some also express the hope that this latest attempt to reconfigure the U.S. health care system will focus on controlling costs, rather than just coverage -- the deliberately limited focus of the ACA. The EBRI forum focused on three key points: Strengths and weaknesses of the current U.S. health system; what panelists foresee happening this year; and what they expect for the future. This paper presents a synopsis of the discussion