In part one of a two-part series on the human resources-related policies of the Republican and Democratic parties, focuses on health policy and the future of the Affordable Care Act (ACA). Party platforms are as much about political philosophy as they are about practical proposals. The Republican platform is no exception, leaning in favor of private sector as opposed to government approaches. The Republican Party platform on healthcare policy generally parallels that of the party’s nominee for president, advocating for the “repeal” of the ACA, including the individual mandate, and supports the sale of insurance across state lines, full deductibility of insurance premium payments, stronger health savings accounts and the importation of pharmaceuticals from overseas.  

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Republicans in Cleveland: Spotlight Healthcare Policy

Fri Jul 22, 2016

The Republican National Convention this week in Cleveland nominated New Yorker Donald Trump as the GOP presidential candidate and adopted an official 2016 “Platform,” a statement of principles and policies Republicans will support during the election campaign. Democrats are expected to adopt a platform statement at their convention in Philadelphia next week.

The Republican platform document addresses policies such as economic growth, taxes, jobs, education, healthcare, national defense, foreign policy, international trade, energy and the environment.

This blog, part one in a two-part series on the Human Resources-related policies of the two parties, focuses on health policy and the future of the Affordable Care Act (ACA).

Party platforms are as much about political philosophy as they are about practical proposals. The Republican platform is no exception, leaning in favor of private sector as opposed to government approaches.

Nowhere is this more apparent than in the section entitled “Great American Families, Education, Healthcare and Criminal Justice.”

On healthcare specifically, Republicans call for repeal of the ACA, President Obama’s signature legislative achievement. The platform document asserts that the ACA has increased insurance premiums, deductibles and drug prices, limiting access to doctors through “narrow networks,” while restricting drug coverage.

Perhaps most significant is the fact that the Republican position on the ACA seems to have evolved from a complete repeal of the 2010 law to saying that it should be “removed and replaced with an approach based on genuine competition, patient choice, excellent care, wellness, and timely access to treatment.”

Further, the Republican platform would “reduce mandates” contained in the ACA, presumably the individual mandate to enroll in minimum essential coverage, and by implication the employer mandate to offer affordable and minimum value coverage to full-time employees. The precise meaning of “reduce mandates” as opposed to repeal mandates is not made clear.

Republicans would also “limit federal requirements” on private insurance and Medicaid and push the pendulum of regulatory power away from the federal government and to the states. In a nod to the most popular feature of the ACA, the platform would guarantee non-discrimination in insurance premiums for people “with pre-existing conditions who maintain continuous health coverage.”

Urging “consumer choice” as a new basis for healthcare reform, Republicans call for “job-to-job” portability of insurance coverage by expanding Health Savings Accounts and Health Reimbursement Arrangements, ending “tax discrimination against the individual purchase of insurance” and allowing consumers to purchase insurance across state lines.

While the platform does not elaborate on “tax discrimination against individual purchase,” it probably refers to the idea that the present-law tax exclusion for employer-provided health insurance premiums is not available to individuals outside of the employment relationship. Republicans have called for full tax deductibility of premiums whether insurance is purchased in the individual market or employer-sponsored.

The Republican Party platform on healthcare policy generally parallels that of the party’s nominee for president. Mr. Trump advocates “repeal” of the ACA, including the individual mandate, and supports the sale of insurance across state lines, full deductibility of insurance premium payments, stronger health savings accounts and the importation of pharmaceuticals from overseas.

Based on the Republican platform and the nominee’s campaign issues statement, it seems likely that if Mr. Trump becomes president much of the ACA would be repealed, including the individual mandate, and the employer “play or pay” mandate would surely be scaled back. But the law would not disappear completely. Instead the ACAwould be reconstituted to preserve popular provisions like the limitation on pre-existing condition exclusions and emphasize a greater role for consumers and the states.

There are other high-profile HR-related issues that did not find expression in the Republican Party platform. Among these is mandatory paid family and sick leave—a growing trend among states and municipalities. Delegates to the Cleveland convention probably decided to reaffirm the party’s longstanding position against mandates and by implication to oppose a federal paid leave mandate.