It came to the surprise of many when the repeal did not occur. With so much uncertainty within the Republican Party, not one healthcare proposal could be agreed upon to replace the ACA.
“President Trump’s promise to repeal it on day one was always more bluster than reality,” says Shan Fowler, owner and principal of Four8 Insights, a benefits and HR consultancy. “But Congress moved from repeal to repeal-and-replace, to repeal-and-delay, and back again over the course of the year. Ultimately, nothing happened.”
Late in the year, Trump signed an Executive Order taking aim at several key components of the ACA, including expanding association health plans, allowing multi-state plans and expanding HRAs for individual coverage.
“These, along with the ongoing will-he-or-won’t-he-pay-the-CSRs saga adding uncertainty to both individual and employer markets that will get a lot of focus in 2018 and the potential to change market dynamic drastically,” Fowler says.