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

Eliminating the Cadillac tax “will likely receive considerable attention,” says Chatrane Birbal, senior advisor for government relations at the Society for Human Resource Management. She notes that standalone bipartisan legislation has already been introduced to repeal the 40 percent excise tax on high cost employer-sponsored health coverage in the form of the “Middle Class Health Benefits Tax Repeal Act of 2017,” sponsored by Senators Mike Kelly (R-Pa.) and Rep. Joe Courtney (D-Conn.).

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

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

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

Meanwhile, health insurance lobby, America's Health Insurance Plans, in a letter this week asked Senate Finance Chairman Orrin Hatch (R-UT) to repeal the Cadillac tax, as well as the health insurance tax (HIT) as part of the committee’s tax overhaul efforts, according to Inside Health Policy.

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

Instant Insights /

Some ACA provisions could be tweaked in other measures

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