If we had to guess right now, it looks like the Affordable Care Act will remain the law of the land. And, whether you support or oppose the ACA, perhaps that’s not a bad thing in the middle of a pandemic. People are scared, and the last thing they need is to worry about losing their current health coverage.
There are several reasons the ACA is likely to survive:
It appears the Supreme Court will once again refuse to strike down the law.
President Biden is a supporter of the existing law and would like to improve and expand it.
Republicans do not have control of the House or the Senate, so they will be unable, at least for the next two years, to pass a law to repeal the ACA. Even then, Biden would have the power to veto it.
That said, we are unlikely to see major changes to the ACA since Democrats will not have the necessary super-majority in the Senate to make any big improvements. They will control the executive branch, though, and that means that Biden could ask the Departments to re-write some of the regulations that the Trump administration put in place. Other regulatory changes could be made through executive action, though it’s unclear at this point what those might be.
One final possibility we need to consider is that the Supreme Court will strike down the law (again, this seems unlikely) with no ability for either party to fully replace the Affordable Care Act. If that were to happen, then we’d fall back to the old system where the various states make decisions about covered benefits and rating rules, subject to other federal laws like HIPAA.
Only time will tell what will ultimately happen, but at least we’re better able to predict the future now than we were just a couple months ago. Stay tuned—as we learn more, we’ll be sure to let you know.