Will the Affordable Care Act be repealed?

The results of the 2016 presidential election are likely to have a big impact on federal tax policy in the coming years – especially as it relates to the Affordable Care Act. To get a sense of what changes might be on the way, the Journal of Accountancy recently spoke with Eddie Adkins, CPA, a partner in the Washington National Tax Office at Grant Thornton, about the future of the ACA. 

Video transcript:

One of the top questions—actually, the top question—that I’m hearing after the election regarding the Affordable Care Act is, “Is it going away? Is it going to be repealed?”

And everyone is speculating about that. You know, it really doesn’t take much speculation. President-elect Trump said during the campaign that on day one of his administration he would ask Congress to repeal it. House Speaker Ryan has said as recently as just a couple days after the election that one of the top priorities is to repeal the Affordable Care Act. And Senate majority leader, Senate leader Mitch McConnell has said that it is one of the top priorities.

And I think it’s also important to note that the House has already voted over the course of the last six years to repeal the Affordable Care Act over 50 times. So there is little doubt that it will be repealed. However, I don’t think it’s going to be repealed in full. The reason for that is that certain provisions cannot be eliminated without a supermajority vote in the Senate, which is 60 votes, and Republicans don’t have that many votes. So a partial repeal is very, very likely. A full repeal is very, very unlikely. So there are questions about, well, which provisions will go away and which provisions will stay.

And that’s really top of mind for folks. And so what’s happened, and the election was very recent, but what’s happening is, already there’s a lot in the press about what the leaders are saying. So there are two provisions in particular that there’s just really strong bipartisan support for. For some reason, these have sort of risen to the top in terms of, these are the things that are just not going to go away.

And one of those is that children can be covered under their parents’ health plan until they are 26. That was enacted as part of the Affordable Care Act, and it’s very, very popular. So it’s not going away. And also another provision that was in the Affordable Care Act—very popular, and has strong bipartisan support—is, and in fact this is one that President-elect Trump, who was interviewed, recently said, “I like this provision very much,” and that is that individuals cannot be turned down for coverage due to preexisting conditions.

So those are going to stay, and I think a lot of other, what we call “market-reform provisions”—the market reforms were not tax-related items under the Affordable Care Act, but were changes to the way health insurance works. So, for example, no limitation on annual benefits, no lifetime limit, those are likely to stay, and the reason is that to change those, to eliminate those, it would require a supermajority vote in the Senate, and the Republicans don’t have that supermajority, which is 60 votes. So those are some of the things that I think will stay.