Leavitt: ACA repeal will likely defer changes for 2 to 4 years
ORLANDO — Former Utah Governor and Health and Human Services Secretary Michael Leavitt said the new administration will repeal President Obama’s Affordable Care Act by April. But that legislation will likely defer changes for 2 to 4 years.
“There is as close to a political imperative as can be established for Congress to do something,” Leavitt said here at the HIMSS17 HX360 executive breakfast on Tuesday. “There’s no way they can pretend the [ACA] didn’t exist.”
Leavitt said that Congress and the Trump administration will need to figure out the individual mandate, sort out Medicaid expansion and keep in mind their commitment to not take insurance away from the 20 million American who enrolled under Obamacare.
“They’re likely going to building on some things that are not necessarily anathema to the Republican ideology,” Leavitt said. “There’s a lot Republicans will build on, change and helpfully improve.”
Both parties, for instance, agree on core tenets - value-based care needs to replace fee-for-service, coordinated care is better than uncoordinated care and costs have to be brought down.
Repeal is one part of the process and Leavitt said that replacing the law with another is a five-phase process beginning with budget resolution, moving on to Executive Orders and rules, then the bill to actually repeal the ACA. Once that happens, Congress will create what Leavitt called Replace 1.0, followed by Replace 2.0.
Whereas Leavitt said the budget resolution has already happened and he expects the repeal bill by April’s end, he doesn’t think that part of the process will have an immediate impact.
“The reality is that it’s not going to unfold rapidly,” he said, citing for example the potential approach to use tax credits to replace the ACA as something that would take the IRS a couple years to prepare for.
Which is why when Congress repeals the ACA, Leavitt expects them to defer the implementation date for two to four years.
“If you are deferring implementation dates for a while, sometimes those can slide,” Leavitt said. “This is going to go on for a while.”
Healthcare is not unique in that sense and, in fact, Leavitt said that the industry is 25 years into a 40-year transition to value-based payments that began with DRGs in the 1980s.
“We ought to think of this not as Obamacare vs. Trumpcare,” Leavitt said. “Its iterative and I have some optimism we’re moving in the right direction. American healthcare system will be a better place.”
This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.