ACA Compared to Repeal/Replace Efforts

Provision

ACA

AHCA

BCRA

Cadillac Tax

·   40% excise tax on certain high-cost health plans eff. 2020

·    Tax delayed until 2026

·   Tax delayed until 2026

Employer Mandate

·   Penalty for not offering minimum essential coverage to all FTEs and their dependents

·   Penalty for not offering affordable coverage that provides minimum value to FTE who receives premium tax credit in Marketplace

·    Penalty reduced to $-0- eff. 1/1/16

·   Penalty reduced to $-0- eff. 1/1/16

Essential Health Benefits

·   Small group health plans must provide EHBs

·   All group health plans may not place annual or lifetime max on EHBs

·    States can apply for waiver from EHB requirements

·   States can obtain waiver from EHB requirements, cost-sharing limits, and actuarial value-level requirements

Form 1095 Reporting

·   Reporting required

·    No changes from ACA

·   No changes from ACA

HSA

·   Max contribution separate from/less than MOOP

·   20% penalty on non-qualified distributions

·    Max contribution tied to MOOP eff. 2018

·    Penalty reduced to 10% in 2017

·    Max contribution tied to MOOP eff. 2018

·   Penalty reduced to 10% in 2017

Individual Mandate

·   Penalty for no coverage

·    Penalty reduced to $-0- eff. 1/1/16

·    30% premium surcharge for coverage gap of more than 63 days eff. 2018

·   Penalty reduced to $-0- eff. 1/1/16

·   6-month wait for coverage gap of more than 63 days eff. 2019

Medical FSA

·   Statutory max on salary reduction

·    No statutory max eff. 2017

·   No statutory max eff. 2018

Medicare Part D – RDS

·   RDS expenses not deductible

·    RDS expenses deductible eff. 2017

·   RDS expenses deductible eff. 2017

Medicare Payroll Tax

·   0.9% tax for certain high-income individuals

·    Tax repealed eff. 2023

·   Tax repealed eff. 2023

OTC Medicine

·   Payable only with a prescription

·    Repealed eff. 2017

·   Repealed eff 2017

PCORI Fee

·   Plan sponsors owe annual fee through 2019

·    No changes from ACA

·   No changes from ACA

W-2 Reporting

·   Reporting of health coverage required

·    Reporting retained

·    Employers must indicate months an employee was eligible for coverage

·   No changes from ACA