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ACA Repeal Could Take Up to Six Years: Will Feds Enforce the Law in the Meantime?


In the wake of President Trump's executive order instructing the federal government to do whatever was legally necessary to ease the burdens of the Affordable Care Act (ACA), little has been said about how long such a move will actually take — until now.

At the National Association of Health Underwriters' annual legislative conference in Washington DC, legislators offered some details and answers that had been lacking up until to this point.

The most eye-opening revelation came from Sen. Lamar Alexander (R-TN), the chairman of the Senate's Committee on Health, Education, Labor and Pension, according to a report by Employee Benefit Adviser.

'Americans deserve a repeal, but...'

Alexander said the full change (aka, ACA repeal) and implementation will take up to six years and only after "concrete alternatives" are created because "Americans deserve to have it repealed, but it needs to be done the right way."

Despite the lengthy process of the ACA repeal — or revision — project, Alexander did make it clear that Republicans planned on getting to work immediately to do away with the more controversial and administratively onerous provisions of the ACA. Of the immediate action Republicans are taking, Alexander said, "[t]hat means, as [Speaker Paul] Ryan has said, we will do most of our legislation on it this year, most before summer."

Alexander also offered some insight into the GOP's plan for tackling what he viewed as the most pressing ACA problem, the individual market, by stating:

We have to send a rescue team in on the individual market. [Health and Human Services Secretary Tom] Price will start with some administrative fixes to stabilize it and once we stabilize it — say, for three years — we can move along and make long-term changes to the individual market and have discussions with state governments about Medicaid.

'Not going to do anything stupid'

Rep. Chris Collins (R-NY) echoed Alexander's sentiments about not rushing the repeal process by stating, "We are not going to do anything stupid. We are not going to leave people out to dry."

Collins also acknowledged the formidable challenge of repealing and replacing such a significant piece of legislation. "It is not easy," Collins said. "We are not going to do something... not well thought out or [that] has unintended consequences."

IRS & the individual mandate

While the GOP was offering the healthcare industry some insight into the future of the repeal efforts, the Internal Revenue Service (IRS) was quietly scaling back its own enforcement efforts. In fact, the agency recently announced it will be accepting individuals' tax returns regardless of whether those taxpayers filled out the line on the tax returns indicating whether they had maintained qualifying health coverage for the 2016 plan year. Specifically, with very few exceptions, individuals were required to indicate whether they had maintained coverage in 2016 or paid the penalty by filling out line 61 on their Form 1040s. And the IRS previously said if line 61 was not completed, it would label the 1040 a "silent return" and reject it.

Now, however, the IRS appears to have had a change of heart and said the line will be optional for 2016 tax filers.

Why the about-face? Trump's executive order on the ACA seems to have been the direct cause of the change in enforcement.

In a statement to, the IRS said:

The recent executive order directed federal agencies to exercise authority and discretion available to them to reduce potential burden. Consistent with that, the IRS has decided to make changes that would continue to allow electronic and paper returns to be accepted for process in instances where a taxpayer doesn't indicate their coverage status.

As employers know, the requirement that all Americans maintain qualifying health coverage — aka the individual mandate — is one of the cornerstones of the ACA.

So that begs the question: If federal agencies are relaxing the enforcement of the individual mandate, will they do the same with employers' ACA reporting requirements? For now, the answer is still "no."

Posted In: Congressional Activity; Affordable Care Act (ACA); Internal Revenue Service (IRS); Department of Health and Human Services (HHS); Executive Branch

Want to know more? Read the full article by Jared Bilski at

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