With the recent election of Donald Trump, there is much uncertainty about the longevity of the Affordable Care Act (ACA) going forward. Throughout his presidential campaign, Trump repeatedly expressed his intent to repeal and replace the legislation shortly after his inauguration.

What is the likelihood of a full and immediate repeal?
Both houses of Congress and the White House would need to work together to significantly alter or repeal the Act, and there would likely be Supreme Court challenges as well. Marshall & Sterling does not expect the ACA, which is inextricably interwoven into our health care system, to go away quickly—and here’s why.

First, Republicans do not hold 60 seats in the Senate, so a full repeal proposal would be subject to a filibuster in the Senate and the Democrats retain more than enough votes to stop a repeal bill.

Second, while Republicans can move to repeal key ACA targets by using a special legislative process known as budget reconciliation (which permits legislation to pass with only 51 votes and not be subject to filibuster), this process has cumbersome features that would likely take months. Further, the reconciliation process only applies to clear federal budget related matters, making large portions of the ACA not repealable through this process.

Finally, without an effective replacement plan, “repeal”/ reconciliation would result in a loss of coverage for 22 million Americans, as estimated by the U.S. Congressional Budget Office (CBO). A Republican replacement plan could not be implemented overnight and, with the GOP still far apart on specifically what kind of alternative to enact, this would present huge political and procedural hurdles.

Change? Yes. Overnight? No.
With the new incoming Trump administration, we expect major changes to the ACA and its many requirements. However, a full and immediate repeal of the Act, which has been in effect for nearly seven years, is highly improbable and replacing or amending it will take time.

Until new laws are passed, or existing laws are modified, you will still need to comply with the current ACA requirements.

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