Obamacare Repeal Could Bring Relief for Colleges, Uncertainty for Adjuncts

Phelan M. Ebenhack for The Chronicle

While running for president, Donald J. Trump said that he would repeal the Affordable Care Act “on Day 1" of his administration. Now, with Mr. Trump just days from taking the oath of office, and the Republican-controlled Congress already working to repeal the act, President Obama’s health-care-reform law appears doomed.

Some college human-resources administrators would not be sad to see it go. Obamacare raised the already-spiraling cost of health insurance for institutions and employees alike, they say, and added more red tape to a complex benefits process.

But what a full or partial repeal would mean for colleges over all remains uncertain. Mr. Trump has said that his plan to replace the Affordable Care Act will provide “insurance for everybody,” but details are scant and the timetable to pass such legislation is unknown. Meanwhile, adjunct faculty members could lose the individual health-insurance coverage they gained through the act.

“It’s anybody’s guess” what’s going to happen, says Brenda Mundell, director of employee benefits at the Pennsylvania State System of Higher Education.

Ms. Mundell, who oversees employee benefits for 14 public universities, looks forward to “some relief from some of the more onerous aspects” of the Affordable Care Act. The law, which was enacted in 2010, includes taxes and fees on employers that cost the Pennsylvania system about $2 million a year, a 2-percent increase in its annual health-benefits costs.

That additional expense comes on top of ordinary health-care costs that have risen by an average of 6 percent annually in recent years. Ms. Mundell calls the taxes and fees “a waste of money.” She would rather use state money to pay claims for state employees, she says, instead of sending it to the federal government, where “we were never going to see it again and never get any direct benefit out of it, nor would any of our employees or covered members.”

The Affordable Care Act also added federal reporting requirements for employers, including tracking the hours of part-time employees to gauge their benefits eligibility, issuing additional employee tax documents, and compiling an annual report. Keeping up with the added paperwork has been “a drain on our limited resources,” says Mark Weinstein, chief executive of the Independent Colleges and Universities Benefits Association, a consortium that provides insurance services for 27 employers in Florida, including 12 private colleges. The law’s reporting requirements eat up dozens of working hours for each large institution, he says.

Other administrators are less sanguine about the law’s demise. “Is it a burden? Not really,” says Maria Martinez, associate vice president for human resources and risk management at Rollins College, one institution that insures its employees through Mr. Weinstein’s organization. The law did raise premiums at Rollins, by about 1.5 percent, and increase red tape, but it also prevented insurance companies from rejecting employees with pre-existing medical conditions, and allowed dependents under 26 years old to remain covered by their parents’ insurance, among other broad-based benefits, Ms. Martinez notes.

(Republican policy makers may retain or recreate in new legislation the aspects of the Affordable Care Act that deal with pre-existing conditions and dependents under 26. Mr. Trump has said that he would like to retain them, and both were included in a health-care-policy agenda released by Republicans last year.)

Rick Williams, director of human resources at Guilford College, in North Carolina, has mixed emotions about a repeal. “The administrative burden is a challenge, so we won’t miss that,” he says. But if getting rid of the extra cost and extra work means that more Americans might lose their health insurance, “I probably wouldn’t make that deal.”

The Employer Mandate

Full-time employees of colleges might not notice any significant changes in their benefits if the Affordable Care Act is repealed, but adjunct faculty members and graduate teaching assistants covered under the law certainly could.

Repeal could lead to a mixed bag of changes in working conditions for adjuncts. The current law says that large employers must provide insurance for employees who work 30 or more hours a week. Some colleges have limited the number of hours their adjuncts work in order to avoid triggering the so-called employer mandate. With the mandate gone, adjuncts might get more hours and earn more money, according to Steven M. Bloom, director of government relations at the American Council on Education.

But that doesn’t seem like a boon to Maria Maisto, an adjunct faculty member in the English department at Cuyahoga Community College, in Ohio, and president of New Faculty Majority, an advocacy group for contingent faculty members. The employer mandate has offered colleges an excuse not to offer health insurance to adjuncts, she says, but it has also forced a conversation about adjunct faculty work, and what counts as full-time and part-time work in a profession like teaching.

With the Affordable Care Act gone, “it’s possible that that conversation could be pushed under the table again,” she says, “and it’s a really important conversation.”

More significant, if the law is repealed, many adjuncts could be among the millions of Americans who could lose their coverage, at least temporarily.

Ms. Maisto could be among them. She and her three children are all insured under the law. With the timing and details of a Republican plan still uncertain, she is concerned that her family’s coverage might be interrupted, or that the Republican replacement, even if it allows for pre-existing conditions, might be too expensive for her to afford. “For my family, the pre-existing-condition mandate has been critical,” she says. “That’s my biggest worry.”

In a strange twist, the likely repeal of the Affordable Care Act might actually ensure that thousands of graduate students get to keep their university-provided health coverage. Last year the Treasury Department and other federal agencies issued guidance saying that colleges that provided subsidized student health insurance to graduate teaching assistants — a common recruiting tool and perk at research universities — were in violation of the current law, since teaching assistants should be insured under the rules governing employees.

The Internal Revenue Service said that it would not crack down on such violations until after the current academic year. Mr. Bloom says that the Obama administration “kicked the can down the road,” to give colleges time to adapt, and to give a new administration — presumably headed by Hillary Clinton — an opportunity to find a solution.

With the Affordable Care Act gone, colleges would be free to offer subsidized health benefits to teaching assistants without restrictions. “The repeal, ironically, might make it easier to provide graduate students health insurance,” Mr. Bloom says.

Lee Gardner writes about the management of colleges and universities, higher-education marketing, and other topics. Follow him on Twitter @_lee_g, or email him at lee.gardner@chronicle.com.