The Council for Affordable Health Care classified the chances of several ACA components surviving as low, medium or high. (Image: Thinkstock)

A health insurance lobbyist who served Republicans in the U.S. House says some components of the Affordable Care Act may survive.

Katie Allen, the executive director of the Washington-based Council for Affordable Health Coverage, gave that assessment in a slidedeck she prepared for the Health Insurance and Managed Care Committee.

The committee, part of the Kansas City, Missouri-based National Association of Insurance Commissioners, included the slidedeck in the packet for a session it held Sunday in Miami Beach, Florida, at the NAIC’s fall meeting. 

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Allen’s group represents a number of clients interested in health policy, including drug manufacturers; Hartford, Connecticut-based Aetna Inc.; Bloomfield, Connecticut-based Cigna Corp.; the Washington-based National Association of Health Underwriters; and the Washington-based National Association of Manufacturers.

Allen predicted that Republican policymakers will try to offer much stronger incentives for people to keep paying health insurance premiums even when they feel healthy; create special programs, or high risk pools, to serve people with health problems; and generally work to make insurance products and programs more flexible.

Allen, who served as a health care legislative assistant to Rep. Michael Burgess, R-Texas, a medical doctor, from April 2014 through January 2015, and as a senior legislative assistant to Rep. Diane Black, R-Tenn., from January 2015 through November 2015, gave the NAIC a chart rating the chances of major ACA commercial health insurance provisions surviving.

She assigned the provisions a survival rating of low, medium or high.

Allen gave some version of the ACA health insurance premium subsidies, a revised version of the current restrictions on medical underwriting, and the provision requiring insurers to let parents keep children on their coverage up till age 26 a high chance of surviving.

Allen gave the ACA individual and employer coverage mandates a low chance of survival.

She said the Obama administration’s effort to restrict the sale of short-term health insurance plans, and the ACA provisions that provided funding for nonprofit exchange user helpers, such as navigators, also appear to be doomed.

She added that some version of the Medicaid expansion program, the public exchange system, the essential health benefits package and the current rating rules have a medium-high chance of survival.

But, if the exchange system and the rating rules do survive, they will probably survive with significant modifications, Allen predicted.

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