Much of the discussion on an ACA repeal has focused on the consequences for the 20 million Americans who gained coverage under the law's main provisions, such as Medicaid expansion, the health insurance marketplaces and changes to private insurance that allow children to remain on their parents' plans until age 26. But people who have health insurance through their employer are not immune to the effects of repeal, according to the Sun Herald.
An estimated 150 million Americans get insurance from their employers and are at risk of losing consumer protections that have become the expectation if Republican lawmakers make good on their promise to repeal the ACA.
Here are nine protections brought by the ACA that could change or disappear with the repeal of the ACA, for both individual insurance plans and employer-sponsored plans, according to the report.
1. Coverage for preventive services. The ACA requires most health plans to cover recommended preventive services — such as mammograms and colonoscopies — with no out-of-pocket payments for patients. It also requires that insurance plans cover all forms of contraception that are approved by the U.S. Food and Drug Administration without any cost sharing.
2. Guaranteed coverage for people with pre-existing conditions. Before the ACA, smaller companies were allowed to refuse to cover or charge more for employees with pre-existing conditions. Large companies were allowed to impose year-long waits before granting coverage to an employee with a pre-existing condition. Under the ACA, such discrimination against employees with pre-existing conditions is illegal, according to the report. President Donald Trump has indicated that he favors keeping this provision in an ACA replacement plan.
3. Long waiting periods. Employers could previously make employees wait an indefinite amount of time before extending eligibility for coverage under the company plan. Under the ACA, companies cannot impose a wait time of more than 90 days.
4. Annual and lifetime limits. The ACA bars employer-sponsored plans from imposing annual or lifetime limits on coverage for "essential health benefits" set by the law. Prior to the ACA, even the most generous plans often had caps on such benefits, according to the report.
5. Caps on out-of-pocket payments. The ACA created annual limits on out-of-pocket costs for individuals and families. In 2017, the limit for individuals is $7,105, and the limit for families is $14,300, the Sun Herald reports.
6. Coverage for dependents up to age 26. The ACA requires all health plans, including those offered by large employers, to cover employees' dependents until age 26, even if they're married, financially independent or live in a different state, according to the report. Republicans have also indicated they would like to keep this provision.
7. Summary of benefits. The ACA requires all health insurers to provide a summary of benefits and coverage in a standard form so consumers can understand their coverage and compare plans.
8. Coverage for mental health and substance abuse. Under the ACA, employers must cover mental health and substance abuse disorder services that are comparable to general medical care.
9. Limited emergency room costs. If a patient is taken to an emergency room that is not part of his or her insurance network, the ACA requires all health plans to charge patients out-of-pocket costs that are equal to in-network rates.