Most business executives want to see the Affordable Care Act repealed, a survey of CEOs, chief financial officers and other senior-level CPAs by the American Institute of CPAs found. But they also expect their company’s health care expenses to rise this year and next, no matter what happens in Capitol Hill deliberations on the fate of the sweeping health care insurance law.

Asked their preference for action on the Affordable Care Act, 61 percent of respondents to the first-quarter AICPA Economic Outlook Survey said they preferred “repeal and replace,” while another 10 percent said they wanted to see the health care coverage program repealed and not replaced. Almost one-in-five respondents (18 percent) said they preferred to leave the law as is. Ten percent said they weren’t sure which option they preferred. The survey questions were fielded before the Trump Administration and Congressional Republicans unveiled their own version of a health care coverage plan, the American Health Care Act, earlier this month.

Despite the uncertainty over health care reform, an overwhelming majority (80 percent) of business executives said they expected at least some additional expense for their employer-provided health care plans this year, with 43 percent saying they expected an increase in the range of six to 10 percent and 26 percent estimating a rise in the one to five percent range. Eleven percent said they expected an increase of 11 to 20 percent.

A similar percentage (81 percent) said they expected an increase in 2018, although in a slightly lower mix than 2017.

“Business executives now cite ‘employee and benefit costs’ as the top challenge facing their companies, “ said Arleen R. Thomas, CPA, CGMA, managing director of Americas Market, Global Offerings & CGMA Exam, Management Accounting for the Association of International Certified Professional Accountants “A year ago, that category was No. 6 on the list, and it’s clear health care costs are a major concern driving this upward shift.”

Business executives said the most popular, currently employed strategies for containing health care costs are higher deductibles for employees (65 percent), higher co-pays (49 percent) and employer-sponsored wellness programs (41 percent). Those three items also top the list for companies contemplating new cost-containment strategies in the coming year. Other strategies include a push toward health savings accounts and a shift to self-insurance pools.

The first-quarter AICPA Business and Industry Economic Outlook Survey was conducted Feb. 7-22, 2017, and included 930 qualified responses from CPAs who hold leadership positions, such as chief financial officer or controller, in their companies. The overall margin of error is less than 3 percentage points. A copy of the report can be found on aicpa.org, with the Affordable Care Act responses starting on slide 43.