Wild card or more of the same?

If HRC gets elected, as I feel is the more likely scenario, we will continue down the path we are on, which will likely support the ACA and continue expanding it, perhaps with a public option and maybe even single payer, although I believe that to be a bigger hurdle than some people feel, and I do not believe that was the intent of it all along. If Trump gets elected, that is way too much of a wild card to even predict. He has stated nothing substantial except assuring us it will be “great, so great, we won't even believe it.” I would welcome some substance behind that.

David Contorno, president, Lake Norman Benefits

A big job

Regardless of the outcome of the 2016 presidential election, the new president of the United States is expected to address many of the consequences of the ACA. For example, the excise tax (Cadillac Tax) was expected by the Congressional Budget Office to produce over $250 billion in tax revenue; however, 75 percent of that revenue was forecast to originate from employers that increased employee compensation following their exit from an employer sponsored plan. Although some employers are leaving the market, these forecasts did not account for employer loyalty to their employees.

Additionally, our new president must embrace the concept that health insurance is expensive because health care is expensive in order to finally address the dramatic rate increases faced by employers and individuals. With 80 percent of health plan premiums used to pay health care expenses, our president will have to address the overwhelming cost of health care services.

Tom Harte, president, Landmark Benefits, Inc.

Real health reform

As we approach the election, the future of the ACA is finally getting serious focus, thanks to off-script comments by former President Bill Clinton. The ACA undoubtedly needs fixes, especially the repeal of the looming excise tax on employer coverage. But while Donald Trump wants to repeal the and replace the ACA with what largely amounts to reconfiguring coverage options and Hillary Clinton wants to increase taxes to stabilize exchange coverage, neither candidate is focusing on what our country needs — real health reform. Both sides should focus as much or more attention to fixing what's driving up the cost of care.

We need to rapidly accelerate the move away from fee-for-service medicine in both public and private health care, to eradicate the financial incentives that drive hospitals and doctors to prescribe more expensive treatments in more expensive settings when less expensive quality alternatives are available, to step up scrutiny of industry consolidation that gives health care systems too much leverage to raise prices, and to assure that state and federal laws do not inhibit the ability for people to access lower cost quality health care alternatives for routine preventive and primary care.

These are the “real” health care reform issues that employers, employees, and all Americans want the next administration and the next Congress to address.

Steve Wojcik, vice president, National Business Group on Health