Forget \u201crepeal and replace,\u201d an oft-repeated Republican rallying cry against the Affordable Care Act.<\/p>\n

House Republicans have advanced a package of bills that could reduce health insurance costs for certain businesses and consumers, partly by rolling back some consumer protections. Rather than outright repeal, however, the subtler effort could allow more employers to bypass the landmark health insurance overhaul\u2019s basic benefits requirements and most state standards.<\/p>\n

At the same time, the Biden administration seeks to undo some of the previous administration\u2019s health insurance rules, proposing to retighten regulations for short-term plans.<\/p>\n

Health policy experts aren\u2019t surprised. Most of the GOP policy ideas have long drawn Republican support, have raised concern from Democrats about reduced consumer protections, and could fall under the theme: Everything old is new again.<\/p>\n

Association Health Plans. Self-insurance. Giving workers money to buy their own individual coverage instead of offering a group plan. These are the buzzwords and, ultimately, revolve around one issue, said Joseph Antos<\/a>, a senior fellow at the American Enterprise Institute, a Washington, D.C.-based think tank. \u201cThe real problem is the rising cost of health care. Always has been,\u201d he said. And that problem, he added, is larger than the proposed solutions.<\/p>\n

\u201cIt\u2019s not clear that this kind of an approach would substantially help very many people,\u201d Antos said.<\/p>\n

The latest round of rules and legislation comes as the ACA \u2014 passed in 2010 \u2014 is now cemented in the system. More than 16 million people enrolled in their own plans this year, and millions more are getting coverage through expanded Medicaid<\/a> in all but 10 states, leading to an all-time-low uninsured rate<\/a>.<\/p>\n

But even with enhanced subsidies for ACA health plans, initially approved in the American Rescue Plan<\/a> and extended through 2025 by the Inflation Reduction Act<\/a>, some people still struggle to afford deductibles or other costs, and employers \u2014 especially small ones \u2014 have long wrestled with rising insurance costs and the ability to offer coverage at all.<\/p>\n

So, what is on the table in Washington? First, a caveat: Little is likely to happen in an election year.<\/p>\n

While the Biden administration\u2019s proposed regulations on short-term plans are likely to go into effect, either this year or early next, the GOP\u2019s House-passed legislation \u2014 dubbed the CHOICE Arrangement Act<\/a>, for Custom Health Option and Individual Care Expense \u2014 is unlikely to win favor in the Democratic-controlled Senate. If Republicans were to retake the Senate and White House, though, it illustrates the health policy direction they could take.<\/p>\n

Here are the broad issues on the radar:<\/p>\n

From the President\u2019s Desk: Limits on Short-Term Policies<\/strong><\/p>\n

These types of plans have been sold for decades, often as a stopgap measure for people between jobs.<\/p>\n

They can be far less expensive than more traditional coverage because short-term plans vary widely and \u201crun the gamut from comprehensive policies to fairly minimal policies,\u201d said Louise Norris, an insurance broker<\/a> who regularly writes about health policy.<\/p>\n

The plans don\u2019t have to cover all the benefits required of ACA plans, for example, and can bar coverage for preexisting medical conditions, can set annual or lifetime limits, and often don\u2019t include maternity care or prescription drugs. Despite notices warning of such policies\u2019 limitations, consumers may not realize what isn\u2019t covered until they try to use the plan.<\/p>\n

Concerned that people would choose this option instead of more comprehensive and more expensive insurance offered through the ACA, President Barack Obama\u2019s administration set rules limiting the policy terms to three months.<\/p>\n