What a GOP Senate could mean for PPACA

November 03, 2014 at 04:55 AM
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Midterm elections will be here this week, and the Patient Protection and Affordable Care Act is still on the minds of voters and candidates.

According to Kaiser Family Foundation, Democrats and Republicans are using PPACA to tell their stories in very different ways. Of GOP health care ads, 84 percent mentioned PPACA — and every ad cast the law in a negative light. Meanwhile, just 15 percent of Democratic ads on health care issues included messaging on the law.

So the big question is: What will happen to PPACA if Republicans take control of the Senate after next week's election?

We asked some industry experts to weigh in and predict PPACA's fate. Here's what they said.

Ed Oravetz 
President, founder of Visicor; Houston

Short answer is, not much. Unlike many, I don't anticipate sweeping changes to the law at this point. My hopes would be the elimination of the employer mandate but I don't see that as a likely outcome. I would expect adjustments to the law in areas such as the Cadillac tax, the non-discrimination rules, and hopefully the employer reporting requirements with, again, the overall hope they eliminate the employer mandate (in a perfect world).

James Slotnick 
Assistant vice president at Sun Life Financial; Boston

It is almost easier to answer what won't happen — a full repeal of the law. What will be interesting to see is how a new Republican majority would work to "chip away" at the law. For example, if the government collects less than is needed to pay out for risk corridor payments, we could see a Republican Senate attempt to block the needed risk corridor funding.

James will be hosting a webinar about this topic called, "Election 2014: The Midterm Election, the ACA, and You," Nov. 5, from 2-3 p.m. EST. Register here.

Erick Gustafson
Head of government relations for Mercer parent, Marsh & McLennan Cos. Inc.; Washington, D.C.

If Republicans win control, it will likely be with 51 seats. Given Senate rules, they won't be able to do much unless their proposals garner support from nine Democrats. That will have a moderating influence on any PPACA changes.

Brian Hicks
Vice president, business development at Piedmont Payment Services; Nashville
Benefits Selling columnist

We assume Republicans would have repeal on their minds, but we can expect more confusion as that effort takes shape. You would expect the rules to change with Republicans in charge, and it's hard to advise your clients when you don't know what you're working with. The good news is that if you're confused, imagine how confused the average employer will be. The need for good advisors should continue to climb. Truthfully, PPACA will likely be a target for overhaul/reform for many elections to come — with every election bringing more changes and more confusion.

Jim Christenson
Field vice president at Allstate Benefits; Philadelphia

The Democrats will keep a majority in the Senate by a 51-49 margin. The Republicans will lose governorships and those will be in some states that have not adopted exchanges. PPACA will go forward and the 100 and under market will continue to decline as more and more employers send their employees to the state and federal exchanges.

Aaron Davis
President of NextLogical Benefit Strategies; Maryland 

If Republicans take control of the Senate, PPACA will become the immediate (and persistent) target for outright repeal, modification and bureaucratic languish. However, all attempts at formal repeal or modification are sure to be met with aggressive opposition, especially from the White House. 

Any bills passed by Congress are sure to be vetoed by the President and Congress will lack a two-thirds majority to override them. The more likely strategy will for Congress to defunding enforcement provisions of PPACA to render it impotent.  One thing is for sure, if Republicans take control of the Senate, brokers and our clients will be in for a wild ride in 2015 as this drama continues to play out.

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