How ACA replacement will affect employers

The Republicans’ Affordable Care Act replacement includes plenty for employers to like. The so-called Cadillac tax on generous employer-sponsored coverage would be delayed to 2025, and the mandate that companies with 50 or more employees must offer affordable coverage would be eliminated, which will be cheered by employers in that range who don’t want to offer insurance.

“That will likely be a relief for those companies,” said Laurel Pickering, president and chief executive of the Northeast Business Group on Health.

But Kathryn Wylde, president and chief executive of the Partnership for New York City, another business organization, cautioned that the conversion of Medicaid to a per-capita financing system could strain New York state’s budget so much that employers might feel the pain. “There’s some private sector relief, but a major public sector impact,” she said. “In New York that usually means we raise taxes. Seldom does the state scale back benefits that they’ve already promised people.” In other words, while New York business owners might benefit from the repeal of ACA-created taxes on health insurance and people earning more than $250,000 a year, those gains could be erased if state and local governments raise taxes to support Medicaid expansion.