The Affordable Care Act is celebrating its six-year anniversary this week, and several aspects of the law will continue to take effect over the next few years.
Here are five key notes on the "next chapter" in healthcare reform based on thoughts from The Hill.
1. There are some initiatives with bipartisan support in Congress, including bundled payments and delivery system reform. Those initiatives will likely continue; CMS' Comprehensive Care for Joint Replacement bundled payment initiative on hip and knee replacements will begin next month and potentially serve as a model for expanded participation and other specialties in the future.
2. The ACA has lowered the uninsured rate through the health insurance exchanges and banning insurance providers from denying coverage based on pre-existing conditions. The law mandates health insurance, or collects a fine. The pre-existing condition ban is popular and such initiatives will likely stay "on the books" even after the next president takes over.
3. Republican candidates for president run on repealing the ACA and unpopular aspects — such as the individual mandate — with various plans to replace healthcare legislation. Donald Trump's plan would allow health insurance sales across state lines, make premiums fully deductible on tax returns and require price transparency from providers. It also establishes individual health savings accounts and restructures Medicaid to a state-run block grant.
4. Democratic candidates for president have various views on what healthcare would look like under their regimes. Hillary Clinton focuses on preserving the ACA with improvements; Bernie Sanders would make a massive overhaul of the healthcare system to create a "Medicare-for-all" system.
5. The Republicans in the House of Representatives continue to draft an ACA replacement plan. The House has tried to repeal the ACA several times but has been unsuccessful, especially after the Supreme Court upheld the individual mandate.