President Donald Trump has vowed to repeal the Affordable Care Act (ACA), commonly known as "Obamacare," as soon as possible after taking office.
A few days before the inauguration ceremony, Trump said he had nearly completed a replacement health care plan, which would include "insurance for everybody" in a "much less expensive and much better" form. And Congress has already taken the first steps toward repealing the ACA.
It's hard to say exactly what repeal would mean for colleges; the incoming Trump administration hasn't released many details yet.
However, there could be a lot at stake, as health insurance costs could change for both institutions and staff members. Lee Gardner of the Chronicle of Higher Education recently asked college experts and stakeholders what they're expecting. Here are some of the potential consequences they predicted.
1. Potential savings on benefit costs
Health insurance is expensive to begin with, and many administrators at colleges and universities say the ACA raised costs.
Institutions paid higher taxes and fees under the ACA. The Pennsylvania State System of Higher Education (PASSHE), for instance, paid an additional $2 million each year—which amounted to a 2% increase on health benefits costs that were already rising before the ACA.
Brenda Mundell, the director of employee benefits at PASSHE, says she would rather pay money to the state, rather than the federal government, to cover state employees' benefits.
2. Potential relief from administrative burdens
Complying with the ACA requires a lot of paperwork for college administrators. Among other things, the law requires them to:
- Report to the federal government on part-time employee hours;
- Issue added employee tax documents; and
- Compile an annual report.
Mark Weinstein, CEO of the Independent Colleges and Universities Benefits Association, says that these requirements have been "a drain on [colleges'] limited resources," since institutions have had to devote many hours to complying with the requirements.
3. Grad students may keep the insurance they have
Subsidized health insurance is a common perk that universities use to recruit graduate students, Gardner notes.
But in 2016, a group of federal agencies determined that this system violated the ACA by failing to treat graduate students as employees. The federal government held off enforcing the decision until the 2017 academic year. But if the ACA is repealed, then universities may no longer need to change how they handle health coverage for graduate students.
4. The employer mandate may vanish
The ACA currently requires institutions to provide insurance to employees working over 30 hours per week. Some colleges responded by limiting adjuncts' hours, but this may no longer be necessary if the employer mandate dissolves with the ACA.
As a result, adjuncts may have the opportunity to work more hours and earn more pay, according to Stephen Bloom, director of government relations at the American Council on Education. But they might also temporarily lose their insurance, Gardner writes.
5. Millions of people may lose their health insurance
One report estimated that 18 million people could lose their health plans in the first year following an ACA repeal if a replacement is not implemented. In addition, the report projected that the number of uninsured U.S. residents would increase to 32 million by 2026 if the ACA's subsidies to help individuals purchase health plans and the law's Medicaid expansion are also eliminated.
One adjunct faculty member who spoke to the Chronicle expressed concerns that if the ACA were repealed, she and her family may lose (or be unable to afford) coverage for pre-existing conditions. However, Trump has expressed support for the ACA's protection on coverage for pre-existing conditions and the provision that allows individuals to remain on a parent's plan until age 26 (Gardner, Chronicle of Higher Education, 1/18).
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