GOP Senate win gives it the clout to change Obamacare

The Republican takeover of the Senate next year opens the door for some changes to the nation's health care law, especially as it relates to what small businesses are required to offer employees. The first move that the Republican-led Senate is likely to take regarding the Patient Protection and Affordable Care Act is to vote to repeal it, just like they did in 2011, 2012 and 2013. The effort, of course, would only be symbolic, said Carolyn McClanahan, director of financial planning for Life Planning Partners. The Republican changes most likely to garner serious consideration would target the employer mandate, which requires businesses with 50 employees or more to offer health insurance. President Barack Obama isn't going to let the provision be eliminated, but there have been discussions about changing the mandate that employers provided healthcare to those with 100 or more employees, Ms. McClanahan said. “President Obama knows he is going to have to compromise on some points,” she said. Financial advisers have complained that they are having trouble finding affordable health care coverage for some of their small business clients. Another area of possible compromise would include increasing to 40 the number of work hours an employee must log per week to fall under the mandate as a full-time employee, Ms. McClanahan said. As passed in March 2010, the current law requires coverage for those who work at least 30 hours. The medical device tax, which imposes a 2.3% excise tax on medical device revenues in order to pay for other parts of the ACA, also may be up for compromise. (Related: Money pours into health care ETFs at fastest pace since 2008) “There are a lot of democratic senators with big medical device makers in their backyards so there will be some bipartisan support for that,” Ms. McClanahan said. Gregory Valliere, chief political strategist at the Potomac Research Group, has said he believes there will be bipartisan support to do away with the medical device tax. Another provision that could be altered is the Independent Payment Advisory Board, which has the authority under the ACA to change the Medicare program, Ms. McClanahan said. It requires Congress have a supermajority vote to overrule the board's decisions. The American Medical Association supports doing away with the board. The 114th Congress is scheduled to meet for the first time Jan. 3. Meanwhile, starting Jan. 1, large employers will face financial penalties for not providing health coverage as stipulated by the ACA. (More insight: Carolyn McClanahan on what other changes to Obamacare Republicans might pursue)