President Takes Executive Actions to Reform Health Care

Yesterday, President Donald Trump signed an Executive Order that overhauls major health care federal regulations and seeks to promote certain less-regulated health insurance plans that do not need to comply with some requirements created by the Affordable Care Act (ACA).

According to the administration, this executive order is designed to ease current health care insurance regulations, and instructs state agencies around the country to permit the sale of less-comprehensive plans, across state lines, that are exempted from some ACA rules. These plans, called Association Health Plans, allow small businesses, and potentially even individuals as well, to associate together to insure themselves or their employees. Such plans are currently subject to stricter regulation under the ACA.

It is expected that these plans may lower costs, and therefore will be more attractive to younger and healthier individuals, potentially encouraging a population of previously uninsured individuals to buy insurance. But these plans will likely be less expensive to consumers because they will be less comprehensive than current plans offered through the ACA marketplaces.

Proponents tout the competition these plans will bring. Opponents believe these plans will undercut the risk pools of the ACA market place, with the healthy and young exiting, leaving older and less healthy people to a newly underfunded pool of insurance.

The order also lifts limits on what are called short-term insurance plans that are already outside the current ACA marketplaces. It also will expand a program allowing employers to set aside dollars, pretax, which their employees could use to pay for their premiums—which some worry might create an incentive for employers to stop offering coverage itself.

The executive order does not make changes itself, and instead directs agencies to issue new regulations or guidance. Those new rules will go through a notice and comment period, a process that could take months.

Additionally, today, the President announced his intent to stop cost-sharing reduction payments to insurance companies under the ACA, saying such payments are unlawful. With insurance companies having factored these payments into their business decisions, it is expected that this action will have significant effects on the private health insurance market, and maybe even the employer based market as well.

These executive actions are the latest reform efforts of America’s health care system after several stalled legislative attempts in Congress earlier this year.

ASA physician leaders and staff will continue to provide updates on health care reform efforts.