As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief.

A full repeal of the ACA would undo all of the law’s changes to Medicare and would increase Medicare spending, primarily by restoring higher payments to health care providers and Medicare Advantage plans. The increase in Medicare spending would likely lead to higher Medicare premiums, deductibles, and cost sharing for beneficiaries, and accelerate the insolvency of the Medicare Part A trust fund. It also would eliminate coverage in the “doughnut hole” of the Medicare Part D drug benefit, a coverage gap that is closing by 2020 under the ACA.

Full repeal of the Medicare provisions in the ACA would increase Medicare spending by $802 billion from 2016 to 2025, according to the Congressional Budget Office.