While the GOP’s efforts to repeal and replace the Affordable CareAct are facing increasing headwinds, there are still a numberof ACA provisions that might be tweaked in other measures. And theCadillac tax is most likely to be on tap first.

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Eliminating the Cadillac tax “will likely receive considerableattention,” says Chatrane Birbal, senior advisor for governmentrelations at the Society for Human Resource Management. She notesthat standalone bipartisan legislation has already been introducedto repeal the 40 percent excise tax on high cost employer-sponsoredhealth coverage in the form of the “Middle Class Health Benefits Tax Repeal Act of2017,” sponsored by Senators Mike Kelly (R-Pa.) and Rep. JoeCourtney (D-Conn.).

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Unions and employer advocacy groups are supporting the measure.In January, the ERISA Industry Committee, a national associationthat advocates for large employers on health, retirement andcompensation public policies, lobbied for Congress to “quickly topass it,” even before the GOP repeal and replacement effort wasintroduced.

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“Employers work hard to design benefits that keeps costs undercontrol,” says James Gelfand, the group’s senior vice president forhealth policy. “Taxing those benefits would only lead to feweremployers offering health benefits and worse options for employees.Changes to the health care system should seek to build on thesuccess of the employer-sponsored system, not punish the part ofthe system that truly works.”

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However, a big hurdle is “replacing the lost $90 billion inrevenue that the Congressional Budget Office expects the Cadillactax would bring in over a 10-year budget window,” Brian Gilmore,lead benefits counsel for ABD Insurance and Financial Servicestells SHRM. "The wrong way to address the lost revenue would be tocap the tax exclusion for employers’ health care costs.”

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Meanwhile, health insurance lobby, America's Health InsurancePlans, in a letter this week asked Senate Finance Chairman OrrinHatch (R-UT) to repeal the Cadillac tax, as well as the healthinsurance tax (HIT) as part of the committee’s tax overhaulefforts, according to Inside Health Policy.

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Other ACA provisions that might be revisited in stand-alonelegislation down the road, according to SHRM, include repealing theemployer mandate, amending the definition of full-time and seasonalemployees entitled to receive health coverage from large employees,and easing employee tracking and IRS reporting requirements foremployers offering health coverage to their employees.

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.