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Sarah Jones, director of Government Affairs for Horizon Blue Cross and Blue Shield of New Jersey

While no one knows what federal healthcare reform will eventually look like, there are some examples that will probably serve as starting points for repealing, replacing and/or repairing the Affordable Care Act (ACA).

President Trump issued executive orders about enforcing provisions of the ACA, but a permanent change to the law would have to come from Congress.

Sarah Jones, director of Government Affairs for Horizon Blue Cross and Blue Shield of New Jersey, has been tracking the issue, and on Friday, she provided an update at the NJBIA Health Affairs Committee meeting.

Congress has begun by using the budget reconciliation process to expedite the process, she said, because reconciliation bills need only a simple majority to pass the Senate. Other legislation is subject to a filibuster, which requires 60 votes to overcome so the vote can be held.

The House of Representatives has passed a budget resolution and instructions have been given to four key committees that will create the legislation—the House Ways and Means, House Energy and Commerce, Senate Health, and the Senate Finance Committees.

Multiple hearings have already been held on a number of issues, including eliminating the individual mandate, certain user fees and Medicaid expansion. H.R. 3762 could be a blueprint for what Congress will do. It’s an ACA reform bill from last session that President Obama vetoed.

“This is a working document,” Jones said. “They are still having hearings on this, and we may still see some changes.”

H.R. 3762 would have immediately repealed the individual mandate that requires everyone to have health insurance and ACA tax increases. The bill also would have repealed the ACA’s premium subsidies and the Medicaid expansion, but with a delayed effective date.

The bill did not contain a change to insurance rules that require access to coverage for people with pre-existing conditions.

Still, at this point, everything is speculation.

Jones served as moderator of a panel discussion on the ACA at the Health Affairs Committee meeting with panelists Jeff Brown, Policy Director, Hospital Alliance of New Jersey; Jackie Cornell, Senior Director, Federal Relations and Regulatory Affairs, New Jersey Hospital Association; and Toby Stark, President of the New Jersey Association of Health Underwriters (NJAHU) and owner of Stark Associates Insurance.