“I think [Congress] will look at pieces of the ACA quickly — score some points by repealing the excise tax and the employer mandate, as well as the individual mandate,” says Brian Marcotte, CEO of the National Business Group on Health, a coalition of 420 mostly large employers.
Getting rid of the Cadillac tax would ultimately benefit most companies. “That tax wasn’t really about taxing rich benefit plans, despite what it was called,” notes Marcotte. “Being indexed to general inflation, when medical inflation was running [well above] that, meant that it would eventually be a tax on all plans.”
Marcotte, for his part, is most concerned about the potential consequences for the ongoing changes in the way medical providers deliver and get paid for their services.
“It’s hard for physicians to do things differently across their patient base,” Marcotte says. “If you’re under a pay-for-performance or alternative payment model, that’s going to trickle down and you have movement in the right direction from commercial payers as well as the government.”
The fear is that the Republican-controlled executive and legislative branches could act to alter or eliminate funding for the cost-sharing program. “We need to continue those payment and delivery reforms, because that’s where the savings is going to come from,” says Marcotte. “We can’t lose sight of how providers are reimbursed and how we provide accountability in the system.”