President-elect Donald Trump's vow to "repeal and replace" the ACA may be prove to be a matter of semantics rather than a dramatic change in healthcare policy, reports Kaiser Health News.
Many of the issues that gave rise to healthcare reform — rising costs, an aging population, mediocre medical results — continue to plague the U.S. today.
Here are four characteristics of the ACA that could exist in some form under replacement legislation, according to analysts surveyed by Kaiser Health Foundation.
1. Health insurance subsidies. Completely eradicating healthcare subsidies, thereby endangering 5 million Americans' coverage, poses a political risk for Republican congressmen. "[Republicans] don't want to be in a position of saying they're just kicking millions of people out into the street," Joseph Antos, a health economist at the American Enterprise Institute, told Kaiser Health News. This leads some analysts to believe a type of healthcare subsidy for the middle class may remain, even it is not ACA tax credits.
2. The 26-year-old insurance cutoff. The most likely provision to survive a Trump presidency is the requirement employers cover workers' children up to the age of 26. The measure is widely popular and relatively inexpensive, analysts said.
3. Payment reform. ACA legislation encouraged and gave rise to a number of initiatives aimed at aligning cost and quality in healthcare services. Daniel Steingart, a hospital analyst at Moody's Investors Service, said he believes the new administration is on-board with value-based initiatives. "I can foresee a scenario where [the administration] gradually expands all those programs," Mr. Steingart said.
4. High healthcare costs. Repealing the ACA will not influence Americans' ability to afford healthcare services or reduce the number of high-deductible health plans. "They could repeal [the ACA] tomorrow and still have a broken delivery system and costs would continue to go up," Don Berwick, who was acting Medicare administrator in President Obama's administration, told Kaiser Health News.