Republicans will control both houses of Congress next year — the GOP secured 52 Senate seats Tuesday and there are still undecided races in Alaska, Louisiana and Virginia — and insurance broker lobbying firms anticipate the new makeup will spur additional votes on the Affordable Care Act.

“Right off the bat, there will have to be a vote to fully repeal the ACA so the new guys are on the record,” says Joel Kopperud, director of government affairs at the Council of Insurance Agents and Brokers.

Since Republicans took control of the House in 2011, there have been 54 votes to either repeal or change the ACA, and those efforts to alter the health care law will continue, says Diane Boyle, vice president of federal government relations at the National Association of Insurance and Financial Advisors. John Greene, vice president of congressional affairs at the National Association of Health Underwriters, expects a repeal effort but calls it “a largely symbolic vote.”

Nathan Reidel, vice president of political affairs at Independent Insurance Agents and Brokers of America, anticipates a piecemeal approach to reforming the ACA and expects Republicans to focus on their top two or three concerns with the health care law. “I really see this as being one of their last chances to do that,” he says.

Boyle says the employer mandate and changes to the Cadillac tax — an excise tax on high cost health plans — will likely impact employer-sponsored insurance the most. Greene says employers will start thinking about problems related to the Cadillac tax: “This means greater shifting and slimming down of benefits.” However, since it’s slated to go into effect in 2018, he believes the issue will be put off.

Kopperud is keeping his eye on the tax reform discussion and increasing the debt limit. “Tax benefits is very much on the table as an easy revenue raiser when the [Obama] administration and GOP budget hawks look to craft a compromise,” he says. “And the tax exclusion for benefits is the holy grail of the industry.”

Kopperud says taxing plans is a risk and could further incentivize employers to leave the market. “That’s not good when you look at the impact that will have on wellness programs and cost reduction measures implemented by companies across the country,” he says. “It’s also shortsighted of lawmakers if they don’t fully consider the amount of subsidies that will be spent out the door to consumers that would have otherwise been covered by employers.”

A GOP-controlled Senate could also mean a repeal of risk corridors, Greene says. They worked well at first, he says, “but the issue has taken on a life of its own so there is [a] good possibility that it is repealed.”

Greene also expects the 30-hour rule to be addressed — and anticipates a bipartisan effort. “Both [Democrats] and [Republicans] agree that it is unworkable,” he says. “The question is, what is the right number? This is really a labor issue because there is no definition of what constitutes full time.”

With the holiday season nearing, it will be interesting to see the impact on employees who work flexible hours, Greene says. “We are hearing from employers that it is having a definite impact on employees,” he says. “Employers are separating employees between full time over 40 and part-timers under 30.”

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