While much has been written about specific aspects of the ACAand how repeal, replace and repair will affect certain populations,the impact on employer-sponsored benefits is more convoluted.

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In the world of employee benefits, to properly understand thepost ACA world, we must reflect on the confluence of how fiveseparate constituents react to the new health insurancelandscape.

The issues and priorities of these five groups: government,carriers, employers, employees, and brokers/consultants, and howthey relate to each other will dictate the evolution of healthinsurance in the post-ACA world.

These insights will illuminate what to expect in a post-ACAclimate as the health insurance landscape continues to evolve underPresident Trump.

Government compliance issues ease

While we all may be a bit weary from the focus on Washington,the fact remains the federal government continues to be the singlebiggest catalyst for changes in the health insurance and benefitslandscape.

For benefits professionals, it is important to recognize thatfor all the politicization around ACA, there is very little focuson the employer-provided benefits space, especially outside of therealm of small employers. The priority for government involvementin repeal-replace-repair is the individual market and Medicaidexpansion.

Having said this, if the Republicans choose to usereconciliation to repeal the ACA with a simple majority, manyaspects of the employer-provided system will be affected.Unfortunately, this will perpetuate the preoccupation withcompliance in the employer space, continuing the trend of non-valueadd expenditure of resources that has plagued the industry for thelast five years.

Carrier mandates relax

Perhaps surprisingly, the second area of significant change inthe post-ACA era will be in the domain of the carriers. Against thebackdrop of the Department of Justice opinions on the two proposedmega-mergers, we expect the greatest impact ofrepeal-replace-repair will manifest itself in the proliferation ofnew products which were “non-compliant” under the ACA.

Related: Can the GOP get a new health carebill?

Whether correct or not, one of the indictments of the ACA isincreased mandates do more to destroy markets in terms of accessand affordability than they do to advance these objectives.

Look for the relaxation of these mandates and the commensurateacceleration of new product development which will inevitablyfollow. Combined with the return of premium reimbursement plans inthe small market, we expect the further commoditization of majormedical insurance as low risk consumers choose less coverage forless premium.

Employers reallocate benefits compensation

Second only to the carriers, the employers have been the biggestvictims of the ACA era. While many have applauded the decline inthe rate of health care inflation, the reality is that benefitscosts continue to grow more than inflation, placing anever-increasing burden on total compensation planning.

Add to this the increased cost of compliance in an environmentwhere employers are trying to reduce administrative costs in theface of a slow growth economy and you can understand the “ACAfatigue” many employers report.

Repeal-replace-repair, while it will bring uncertainty in thenear term, is likely to lower the burden on employers and allowmore strategic thinking about how they allocate compensation tobenefits.

The increasing age diversity of their employees will force themto consider altering this allocation in favor of financial wellness(retirement and student debt) perhaps at the expense of traditionalhealth benefits. The war for new talent precipitated by near fullemployment in skilled professions will only exacerbate thistension.

Employees wise up on benefit choices

For employees, the impact of the politicization of health carewill continue to cloud their perception of their role in choosingand consuming the benefit programs offered by their employers.

Related: Dems brace to defend ACA

While much has been written about the promise of “consumerism”to change the hyper-inflationary nature of fee-for-service healthcare, it is apparent that the deadly combination of employeeilliteracy and entitlement about employer-provided health insuranceis a greater impediment to real reform in the way health care isconsumed in this country.

With the potential deregulation on mandated benefits and theincreasing availability of retail health care alternatives, it willbe incumbent on all the constituents to accelerate the employees’education and appreciation for employee benefit choices customizedto their informed perception of need and risk mitigation.

Brokers/consultants rise to the challenges

And now, the elephant in the room, the impact on brokers andconsultants. One of my early mentors said, “There is profit inconfusion.” For the skilled practitioners, I think they would agreethat the net effect of the ACA was increased opportunity. It isimportant to note however, that this opportunity required focus onnew disciplines.

No longer were the skills of customer relationship management,procurement management and vendor management sufficient to satisfythe needs of their clients. The best players were forced to developexpertise in compliance, regulatory impact, benefits technology andinternal human resources processes that their predecessors couldignore. This, the low cost of money and the aging workforce ofbenefit producers has contributed to the continued wave of firmconsolidation which changes the nature of competition.

Additionally, the widely publicized fall of market disruptorswill have a chilling effect on innovation for the near term. In thepost-ACA era, benefits professionals will be challenged to balancerevenue, client retention and cost-of-service pressures in anenvironment where the future is uncertain.

The post-ACA era promises to be as exciting as the last fiveyears. To paraphrase Richard Epstein on a separate topic, the realdilemma is that the people working on the problem lack thetechnical expertise and the political agnostic orientationnecessary for real change.

In the meantime, successful participants in this marketplacewill be forced to be both diplomats and opportunists, acutely awareof the issues and priorities facing all of the importantconstituents and balancing these to the most optimum outcome. I,personally, am comforted that we have some of the most creativepeople I know working on this challenge.