As President-elect Donald Trump has not been very forthcoming over his plans for office and what he intends to do, primarily in the benefits arena, many experts are in the dark about Trump’s views on prescription drug costs, retirement benefits and overall healthcare.
What is consistently known by all is that Trump does intend to begin dismantling the ACA. To shed some light on what could happen the coming years, several players in the benefits field shared their ideas on what a Trump presidency might look like for the next four years.
Bill Bade, consulting actuary for Milliman
The supplemental benefits market has undergone unprecedented change and growth since the introduction of the Affordable Care Act. In particular, high-deductible health plans create an opportunity for carriers, distribution partners and technologies to build compelling solutions to perceived gaps in medical coverage. At the same time, state and federal government proposals to restrict supplemental products remain a concern to our clients. Based on our survey of carriers, the regulatory climate is the No. 1 risk to the hospital indemnity market, beating out other risks such as competition. I am anxiously waiting to see how Donald Trump’s healthcare policies will differ from President Barack Obama.
Joe Ellis, senior vice president of CBIZ Benefits & Insurance Services
Trump’s plan to repeal the ACA will be met with ample opposition. He promises to introduce legislation within his first 100 days. His reforms are significant, involving a myriad of provisions of the ACA. Trump will focus on free market solutions. The individual mandate and employer mandate will be targets of his plan, without which begins the unraveling of ACA. He will continue the restrictions on exclusions for pre-existing conditions, and make sure people with coverage will not lose it. And I believe he will re-introduce traditional underwriting in health coverage. This will not be an attempt to exclude people from but to allow insurers to assess risks and charge accordingly. While difficult from a state regulatory perspective, Trump will try to open the doors to carriers selling products across state lines.
Shan Fowler, senior director of product strategy at Benefitfocus
Get ready for a repeal of Obamacare, sort of. Certainly both Trump and congressional Republicans would act fast to symbolically slay the ACA dragon that has vexed them for the past six years. Yet, there’s enough downside to repealing popular ACA features like no preexisting conditions and dependent coverage to age 26 that “repeal and replace” may look more like “refine and rebrand.”
[On] Trump’s plan to provide tax breaks to individuals buying health insurance on the individual market, one of Obamacare’s bigger failures is leaving non-subsidy-eligible families exposed to hefty premium increases without the offsetting benefits of employer-based or subsidized coverage. It’s the kind of plan that Trump specializes in — populist in its appeal, yet without details on how he’ll pay for it.
Strategically, a Trump win may put Paul Ryan and House Republicans in the driver’s seat of healthcare reform. Trump, like Nixon, doesn’t seem overly interested in healthcare reform except as retribution against Obama and Democrats. That perspective, combined with a lack of many details around his health policy, might leave a vacuum of broad healthcare reform ideas that congressional Republicans may be all too willing to accept. So, in the same way that Nixon let Democrats in Congress take the lead on major domestic laws like the Clean Air Act and Clean Water Act so that he could focus on opening up China and fighting the Soviets, so too may Trump pawn off his healthcare reform ideas to Congress so he can focus on building a huge wall.
Jeff Oldham, VP of consumer strategy at Benefitfocus
We already know that Trump is all about HSAs, and we can assume that we’ll be seeing a lot more implementation across younger generations that can afford high-deductible insurance plans.
This will be interesting in light of Trump’s plan to lower the overall cost of healthcare. We may soon see insurance sales competing across state lines to drive down cost. If Trump moves forward with his immigration reform plan, we may also see costs decrease as he ceases to provide healthcare to undocumented immigrants.
Kristi Savacool, CEO of Aon Hewitt
In the coming weeks, U.S. business will assess the implications of the election for policies enacted under President Obama and what may change under President-elect Trump. Given that employee benefits for American businesses are generally regulated by federal officials, a change in presidential administration could bring changes in policy that will impact Aon’s clients. Companies will look to Aon to help decipher issues and design and develop strategies that position clients for success in the short and long term.
In health, Aon will be keeping an eye on President-elect Trump’s plans to repeal the ACA. President-elect Trump’s proposed paid leave programs will also be something that employers will want to follow.
From a retirement perspective, one of the biggest issues Aon will be watching is whether President-elect Trump will reverse the DOL’s fiduciary rules, which could essentially “undo” many of the changes that plan sponsors and others in the industry have made, or planned to make in order to comply with the rules.
No matter who is in office or the platform he or she pursues, it’s important to note that the underlying issues Aon’s clients face are unchanged. Pension obligations loom large as the population ages, individuals are being asked to take on greater responsibility for both their healthcare and retirement security and they are unprepared to do so, population health is declining and people are living longer. These issues don’t change with a new president or Congress, but they are issues that every employer needs to address.
Sam Smith, president at Genesis Financial & Insurance Services
My sincere hope is … that we will somehow find ourselves with a Congress that is willing to come back into session and begin doing the nation’s business and embark on the long process of healing and working together on the immensely important issues that confront us. If they can do this, the future is bright both for our industry and for our country. If they can’t, God help us.
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