Democrats made defending the Affordable Care Act (ACA) and expanding Medicare key pledges during last year’s congressional campaigns, and those issues helped them win control of the House in the new 116th Congress. Senate Republicans increased their majority by two seats to a total of 53, but Democrats retain substantial leverage in a chamber where 60 votes are required to advance most legislation.
Looking ahead to the 2020 elections and spurred in part by December’s Texas federal district court ruling that the now penalty-free individual mandate is unconstitutional, and as a result, the entire ACA should be struck down (for now, the entire ACA remains intact), House Democrats plan to keep their ambitious healthcare agenda front and center this year with hearings and legislation.
An early start to the campaign season will leave little time for legislating, however, and Democrats must deal with some substantial intra-party divisions over policy details, such as how to expand coverage through Medicare. Moreover, much of what they may be able to move through the House will stall in the GOP-led Senate. Republicans also lack a coherent policy strategy since failing to repeal and replace the ACA, though they effectively repealed the law’s individual mandate with the 2017 tax cut law.
While all this may make major health policy changes unlikely in 2019, any measures that might be signed by the president will likely focus on further delaying the controversial Cadillac tax and other ACA taxes, and on affordability issues such as drug pricing and “surprise” medical bills from out-of-network providers.
Here’s my take on the most important legislative issues for employers in 2019. Click on the issues you’d like to read about.