Some ACA provisions could continue temporarily post-repeal

Repeal of the Patient Protection and Affordable Care Act (ACA) and its associated taxes could come quickly but changes, possibly including changes to the ACA’s tax provisions, may not be in place until 2018 or later, a Republican member of Congress said on January 5. At the same time, Democrats in Congress continue to urge reforms and improvements to the ACA.

The ACA created a host of new taxes, including the medical device excise tax, the excise tax on high-dollar health plans (known as Cadillac plans), the net investment income tax and the additional Medicare tax. The ACA also imposes a shared responsibility requirement on certain individuals and employers. Since passage of the law in 2010, the Treasury and the IRS have issued regulations implementing these taxes.

“We will repeal it quickly,” Rep. Chris Collins, R-N.Y., said on January 5. “The replacement is something you’ll see…sometime in the June, July time frame. There’s not going to be any changes in 2017. There’s not going to be changes in 2018. So we’re talking about new plans in 2019 or later,” he noted. Collins, who has served on the House Energy and Commerce Health Subcommittee, did not specify which components of the ACA could remain in place post-repeal and pending replacement.
House Speaker Paul Ryan, R-Wis., addressed the ACA at press conference on January 5. “We’re going to get this law repealed. We’re going to get this law replaced. And we’re going to have a transition period,” Ryan said.

Also on January 5, Sen. Joe Manchin, D-W.Va., discussed ACA-related taxes. According to Manchin, repeal of all of the ACA’s taxes would cost $2.35 trillion in lost revenue, “most at the high top-end income earners.”

Sen. Tim Kaine, D-Va., said he and his Democratic colleagues are open to dialogue about improving the ACA. “Can this law be improved? Can the health care system be improved? Sure, it can. The time to work to make improvements is right now before a repeal vote,” Kaine said.

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