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PACE could be a template for more ACA changes

Law that halts expansion of small-group market had rare bipartisan support

A new law that halts expansion of the Affordable Care Act's small-group market shows that it is possible, after all, to make bipartisan changes to the president's signature healthcare law.

Working in tandem to push the PACE Act through the Senate were Tim Scott (R-S.C.) and Jeanne Shaheen (D-N.H.), two lawmakers with very different views of the ACA. But they both agreed on the pressing need to fix an ACA provision that would have defined small employers as companies with 100 or fewer employees instead of the current 50-or-fewer rule.

The provision, which would have taken effect Jan. 1, was intended to stabilize the small-group market by adding more employers to it, FierceHealthPayer has reported. Yet many experts expected the change would have disrupted the market considerably, as small-group market employers have to offer a set package of benefits and insurers don't have as much leeway when setting their premiums for this group.

Scott and Shaheen's legislation instead leaves it up to states whether or not to expand the small-group market definition.

Both senators think their success in passing the law may set a precedent for future tweaks to the ACA--and they already have their sights set on the much-criticized Cadillac tax and the medical device tax, the National Journal notes.

But achieving such a feat again will require a change to the law that is widely supported and won't increase the deficit, Washington and Lee University law professor Timothy Jost tells the publication. Both the medical device tax and Cadillac tax, he says, fail that litmus test.  

Lawmakers, too, are doubtful. "I don't want to extrapolate from that to say that this is an opening or a harbinger," Sen. Robert Casey (D-Pa.) told the publication. "I think these things tend to be case by case."

To learn more:
- read the article

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