With President-elect Donald Trump, HR leaders know that post-election ACA changes are likely, and the overall direction of health care reform could shift in the coming months and years. HR leaders also know that health insurance benefits are highly valued by employees and are a cornerstone of a benefits package designed to attract and retain the best employees.

Balancing organizational strategy and goals with ACA compliance is an ongoing effort, and there could be plenty of changes to watch out for once the Trump administration takes over. Here's what HR leaders should keep an eye on in terms of possible upcoming health care reform.

Will the ACA Be No More?

Not necessarily. President-elect Trump campaigned on the promise that he'd repeal the ACA on day one, according to DonaldJTrump.com. However, his stance has softened somewhat, and he seems open to the possibility of amending the law. That said, the Trump administration will be working with a Republican majority in the U.S. House of Representatives and the Senate, who have repeatedly passed bills to repeal or defund various aspects of the ACA.

It's likely Congress will focus on a reconciliation bill that would repeal various spending-related provisions of the ACA. The bill might end up similar to Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (HR3762), which passed the House and the Senate in 2015 but was vetoed by President Obama, according to the White House.

Still, HR3762 would not have fully repealed the ACA. Reconciliation bills, which need a simple majority to pass, can only be used to address spending-related provisions. In fact, some parts of the ACA that can't be addressed by a reconciliation bill are among the things that Trump has indicated he'd like to keep.

Will ACA Compliance Still Be Part of an HR Leader's Role?

Possibly, although we don't know at this point how much of a role employers might play in health care reform going forward. HR3762 would have eliminated the employer shared responsibility provision penalties, which would take a significant burden off employers. For 2016 informational reporting, however, HR leaders must assume that the ACA will be unchanged, since informational reporting has to be completed in early 2017 — before the details are worked out in terms of amending or repealing the ACA.

Will the Exchanges and Premium Subsidies Still Exist?

Employers who currently direct some employees to the health insurance exchanges will need to keep tabs on what goes on in the individual market, too. This could be an issue for organizations with many part-time, variable hour or seasonal employees who aren't eligible for employer-sponsored insurance.

HR3762 included a two-year delay before subsidies were to be eliminated. If a similar bill is introduced in 2017, it's likely that subsidized individual market plans will continue to be available in the exchanges throughout 2017 and probably 2018. But this is an issue that some employers will need to watch closely if they have employees who rely on the individual market.

What's the Buzz About HSAs?

HDHPs and HSAs are likely to become more prominent under a Trump administration, as they're integral to Trump's plan and the blueprint that House Republicans published earlier in 2016. HSAs have been growing in popularity with employers and employees over the last decade, as they offer some substantial benefits. HSAs could eventually have higher contributions limits, according to a health care policy paper published by House Republicans in June 2016.

It's realistic to expect that an ACA replacement package could be implemented by 2018. For organizations that don't yet offer an HDHP option, now might be a good time to consider adding one, and fielding questions from employees about how HDHPs and HSAs work. A benefits vendor can help with this, and will be able to provide guidance in terms of what the expanded HSA guidelines would mean, and the role that HDHPs and HSAs will play in future benefit packages.

Looking Ahead

There's no doubt President-elect Trump's win will bring about changes in terms of the ACA and ACA compliance. But changes aren't likely to happen overnight. Lawmakers will need time to establish a replacement for the ACA. The employer mandate could be repealed (HR3762 would have repealed it retroactively), but the most pressing ACA compliance tasks have to do with 2016 informational reporting, and we have to assume that must be completed as scheduled. But no matter the possible changes to the ACA, partnering with a compliance expert should help your organization navigate these evolving compliance needs.

For more information about the future of the ACA, view a webcast that will offer helpful insights into what's possibly to come.

Tags: aca Healthcare Change Management