This week, the Trump administration announced plans to dismantle the Small Business Health Options Program, or SHOP, the part of the Affordable Care Act that created online insurance marketplaces for small businesses.
According to the Los Angeles Times, “moving to end the ACA’s small-business enrollment system by 2018 represents the first public step by the Health and Human Services Department to implement an executive order President Trump signed his first night in office, directing agencies to ease regulatory burdens of the healthcare law.”
As of early 2017, nearly 230,000 people were covered through SHOP health plans — a fraction of the 4 million the Congressional Budget Office estimated would enroll for coverage through SHOP in 2015.
The specifics of the impending SHOP change are a work in progress, and federal health officials told the L.A. Times Monday that “they plan to propose a new federal rule to take effect in January.”
The announcement comes on the heels of the House of Representatives’ recent vote to repeal and replace major portions of the Affordable Care Act (ACA); however, the passage of the House legislation does not signal a quick and easy journey to a new health insurance system.
In fact, said Shawn McBurney, the Society of American Florists’ senior director of government relations, signing the American Health Care Act (AHCA) into law is likely to be a long and arduous process.
“The first step was March 24, 2017, when House Republican leaders cancelled a vote on similar legislation due to opposition within their own ranks,” McBurney explained. “Then, after the AHCA was narrowly approved by the House on a vote of 217 to 213 with 20 Republicans voting against it, the bill went to the Senate where it was pronounced dead on arrival.”
The Senate has a long history of taking its time to “cool” legislation passed by the House, McBurney added.
“With health care legislation, senators have made it clear they intend to do their own thing and not be swayed by the House bill or the administration,” he said.
Republicans in the Senate have formed a working group to develop an approach on health insurance legislation. “We’re starting over from a clean sheet of paper here,” Sen. Bob Corker (R-Tennessee) has told reporters. “I don’t think you’re going to see an effort to modify it. It’s an effort to write a new bill.”
Even if Senate Republicans pass their own version of a health-care bill, it would have to be reconciled with the House version, McBurney said.
“Getting the House to agree on their own plan was a challenge, and getting enough House members to sign on to whatever the Senate decides to pass will be no less a challenge,” he said. “The effort has also laid bare the partisan divide and political infighting that exists in Washington, DC. The AHCA received no Democratic votes in the House — just as the ACA received no Republican votes when it was approved by Congress in 2010.”
The Senate’s work on healthcare legislation is likely to take a long time.
“Some even predict it won’t happen until next year,” McBurney said.