In health care, anything could happen next.
From the beginning of his campaign
If he hopes to carry through on his promise, President-elect Trump will have to figure out how to unravel various elements of a law that has altered products sold by insurance companies, spurred providers to change the way they deliver care and saddled business with new taxes, rules and requirements for insurance coverage.
The health care system is still adjusting to the dictates of the ACA - health care costs are rising, doctors are hard to find and tax penalties are loomingfor businesses offering overly generous health benefits. At the same time, the ACA has increased the number of Americans who have health insurance - an estimated 20 million people gained access to health insurance since the law's passage, according to the
The law's repeal would have its greatest impact on the marketplace for individual health plans and the federal subsidies that help Americans afford coverage, said
Business owners, meanwhile, are focused on potential repeal of the so-called
At least one local health care executive was concerned about the details.
"Trump has said he wants to repeal and replace the ACA without really saying how," said Dr.
Trash or tweak?
Midstate insurers would be happy with some modifications to the law. Their priorities include reforms that would allow insurers to offer younger, healthier people more attractive premiums, according to
Under existing law, insurance companies are not allowed to set premiums based on a person's health status or age, as they were before the ACA went into effect.
The idea was that requiring everyone to buy health insurance would usher more people into the market, balancing out costs so that sicker people weren't paying more than healthy people.
Instead, healthy people have tended to forgo health insurance and pay a fine, so everyone is now paying more, according to Shirk.
Highmark, which said it has lost millions of dollars as a result of the ACA, pointed out that loopholes in the health care law are partly to blame for rising costs.
For instance, people can sign up for insurance when they are sick, and then drop their plan when they get well.
That loophole needs to be closed, Highmark spokesman
In addition, he said, the federal government must live up to its financial commitments to insurers under the ACA, Perri added.
The federal government promised to cover certain ACA-related costs for insurers between 2014 and 2016 as they adjusted to a new market.
Some insurance companies, including Highmark, are suing because they never received the money.
As it has been for several decades, the biggest challenge for the new president will be the continuing rise in health care costs,
Employers can expect a 6 percent increase in health benefit costs in 2017, while employees will likely spend about 5 percent more in monthly premiums, according to a survey by the