President-elect Donald Trump has repeatedly promised to repealthe Affordable Care Act and replace it with something, well, moreaffordable.

|

Related: Trump outlines health careplan

|

Beyond that broad declaration, though, Trump has been less thanforthcoming with details about what exactly he would do, leading towidespread uncertainty in the health care industry. (And in aninterview with CBS over the weekend, he said he wanted to keepcertain aspects of the ACA: "See "Trump now wants to keep popular Obamacareprovisions, scrap the rest.")

|

Related: The election is over: 3 health carepredictions

|

Nonetheless, there are many things companies, health care andotherwise, can be doing now to prepare for the potentialdismantling of the six-year-old law, experts say.

1. Know who's representingyou

General counsel should be communicating with their company'strade association to ensure that what the organization is fightingfor aligns with the company's best interests, says Eugenia Pierson,senior policy advisor and head of health care legislative advocacyat Arnold & Porter.

|

This includes doing a "gut check" about which ACA provisionshave been effective for the company and which have beenchallenging, she adds. "Think through who's representing you inCongress and make sure those agendas are on track, that they're thesame," Pierson says. "And to the extent they're not, considergetting engaged."

|

In terms of the intensity of activity among stakeholders, legaldepartments should prepare for a landscape similar to that in 2008,2009 and 2010, Pierson says. "If I were a GC, I would want to planfor that level of engagement as the new administration starts tothink about how they're going to unwind [the ACA] and what they'regoing to replace it with," she says.

2. Do an inventory andevaluation

Large self-insured employers also should be looking at theircurrent insurance coverage, including the types of benefits theyoffer their employees today, says Michele Madison, a partner in thehealth care practice of Morris, Manning &, Martin.

|

Adds Sandra Hunt, a principal in PwC: The company should "do aninventory of what they've changed in benefit design specificallybecause of the ACA and evaluate what has been beneficial forthem."

|

This includes an examination of the number of part- versusfull-time employees, Madison and Hunt say.

|

With the repeal of the ACA, a provision of which requires largeemployers to offer affordable health coverage that provides minimumvalue to full-time workers, "you could see more people going fulltime," Madison says.

|

|
Photo: iStock

3. Always remember complianceduties

Don't ignore your continued compliance obligations under thecurrent ACA, says John Chesley, a partner and longtime member ofthe health care group at Ropes & Gray.

|

"The pressure on providers to self-examine and self-report hasbeen ratcheted up and made the compliance environment hotter,"Chesley says. "It's an important source of focus for thegovernment, and [Trump] has made clear that he wants to reducewaste, fraud and abuse, so that agenda is going to continue."

|

Such compliance includes meeting the March 31 deadline foremployers and health coverage providers to report certain coverageinformation to the IRS, says Warren Kingsley, a partner and leaderof the employee benefits practice at Arnall Golden Gregory.

|

Companies should be collecting that information from vendorsnow, as the government, unlike last year, has not yet announced anextension to accommodate unprepared vendors, Kingsley says.

|

Employers also should keep detailed records, includingemployees' dates of hire and hours worked per month, to support theinformation included in the report, he adds.

4. Health care companies haveunique considerations

For health care companies, make sure your regulatory, complianceand government affairs departments are operating as they should andcommunicating with one another so that all relevant parties areaware of the game plan, says Arnold & Porter's Pierson. "The GCneeds to make sure that there is a cohesive strategy and thateveryone is communicating to the extent that when changes do come,everyone stays focused on whatever that common strategy is," shesays.

|

In addition, regardless of what a revamped ACA precisely wouldlook like, we can expect "consumer-driven health care," based onthe premises of deregulation and increased competition to reducecosts, says Morris Manning's Madison.

|

This means increased competition for hospitals, but, on theother hand, more opportunities for them to grow and develop newfacilities, Madison says.

|

Also, the elimination of the essential health benefits, coverageof which is required by the ACA, could allow patients to "pick andchoose," she adds.

|

Thus, health care companies should be asking, "'What are theservices we think patients want the most? Where do our electiveprocedures come from?' and then developing resources around thoseservice lines that patients would utilize," Madison says.

|

Finally, if the Republicans replace the ACA's subsidies with theHouse's "Better Way," which was adopted last summer and calls forrefundable tax credits and health savings accounts, fewer peoplecould afford insurance, so hospitals should be thinking about theircharity care programs, says Thomas Bulleit, a partner at Ropes& Gray.

|

"What will that mean for the kind of care they are required toprovide? What will that mean when they have more uninsured peopleshowing up again?" Bulleit says.

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

Kristen Rasmussen

Kristen Rasmussen is an Atlanta-based reporter who covers corporate law departments and in-house attorneys.