Trump Takes New Whack At Obamacare With Executive Order

President Donald Trump shows an executive order on health care that he signed in the Roosevelt Room of the White House, Thursday, Oct. 12, 2017, in Washington. (AP Photo/Evan Vucci)
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WASHINGTON (AP) — President Donald Trump directed his administration Thursday to rewrite federal rules so consumers can have wider access to health insurance plans featuring lower premiums. He called his new executive order a “beginning” and promised more actions to come.

Frustrated by failures in Congress, Trump is moving to put his own stamp on health care. But even the limited steps the president outlined Thursday will take months for the federal bureaucracy to finalize in regulations. Experts said consumers should not expect immediate changes.

“With these actions, we are moving toward lower costs and more options in the health care market,” Trump said before he signed his directive in the Oval Office.

But the changes Trump hopes to bring about may not be finalized in time to affect coverage for 2019, let alone next year.

Trump said he will continue to pressure Congress to repeal and replace former President Barack Obama’s Affordable Care Act, better known as “Obamacare.”

One of the main ideas from the administration involves easing the way for groups and associations of employers to sponsor coverage that can be marketed across the land. That reflects Trump’s longstanding belief that interstate competition will lead to lower premiums for consumers who buy their own health insurance policies, as well as for small businesses.

Those “association health plans” could be shielded from some state and federal insurance requirements. But responding to concerns, the White House said participating employers could not exclude any workers from the plan, or charge more to those in poor health.

Other elements of the White House plan include:

—Easing current restrictions on short-term policies that last less than a year, an option for people making a life transition, from recent college graduates to early retirees. Those policies are not subject to current federal and state rules that require standard benefits and other consumer protections.

—Allowing employers to set aside pre-tax dollars so workers can use the money to buy an individual health policy.

“This executive order is the start of a long process as the gears of the federal bureaucracy churn, not the final word,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.

It’s also unlikely to reverse the trend of insurers exiting state markets. About half of U.S. counties will have only one “Obamacare” insurer next year, although it appears that no counties will be left without a carrier as was initially feared. White House officials said over time, the policies flowing from the president’s order will give consumers more options.

Democrats are bracing for another effort by Trump to dismantle “Obamacare,” this time with the rule-making powers of the executive branch. Staffers at the departments of Health and Human Services, Labor and Treasury have been working on the options since shortly after the president took office.

The president’s move is also likely to encounter opposition from medical associations, consumer groups and perhaps even some insurers — the same coalition that so far has blocked congressional Republicans from repealing Obama’s Affordable Care Act.

State attorneys general and state insurance regulators may try to block the administration in court, seeing the plan as a challenge to their traditional oversight authority.

As Trump himself once said, health care is complicated and working his will won’t be as easy as signing a presidential order.

Experts say the executive order probably won’t have much impact on premiums for 2018, which are expected to be sharply higher in many states for people buying their own policies.

Sponsors would have to be found to offer and market the new style association plans, and insurers would have to step up to design and administer them. For insurers, this would come at a time when much of the industry seems to have embraced the consumer protections required by the Obama health law.

Depending on the scope of regulations that flow from Trump’s order, some experts say the alternatives the White House is promoting could draw healthy people away from “Obamacare” insurance markets, making them less viable for consumers and insurers alike

But conservatives such as Sen. Rand Paul, R-Ky., believe the federal government has overstepped its bounds in regulating the private health insurance market. They argue that loosening federal rules would allow insurers to design plans that — although they may not cover as much — work perfectly well for many people.

About 17 million people buying individual health insurance policies are the main focus of Trump’s order. Nearly 9 million of those consumers receive tax credits under the Obama law and are protected from higher premiums.

But those who get no subsidies are exposed to the full brunt of cost increases that could reach well into the double digits in many states next year. Many in this latter group are solid middle-class, including self-employed business people and early retirees. Cutting their premiums has been a longstanding political promise for Republicans.

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Notable Replies

  1. Trump claims these short-term health associations, now expanded to a year instead of 3 months “would be better” and “not cost us anything”. In the history of man, when has that been true? It has been tried before (MEWAs), with terrible results, and will tend to destroy ACA with customers fleeing to a cheaper insurance that will not provide adequate coverage.

    Additionally, the timing of this is horrendous. ACA sign-ups start Nov 1, and there will be legal challenges and delays, but Trump says this will be available 2018. People will not sign for ACA, thinking there is a cheaper option, and may be left with nothing at all. But Trump just doesn’t give a crap about anyone.

    “Back in 1992, the Government Accountability Office issued a scathing report on these multiple employer welfare arrangements (known as MEWAs; they’re pronounced “mee-wahs”) in which small businesses could pool funds to get the lower-cost insurance typically available only to large employers.
    These MEWAs, said the government, left at least 398,000 participants and their beneficiaries with more than $123 million in unpaid claims between January 1988 and June 1991.
    Furthermore, states reported massive and widespread problems with MEWAs. More than 600 plans in nearly every U.S. state failed to comply with insurance laws. Thirty-three states said enrollees were sometimes left without health coverage when MEWAs disbanded.” https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/10/12/the-health-202-trump-s-executive-order-has-a-history-and-the-government-says-its-not-all-great/59de6c4930fb0468cea81e8f/?utm_term=.8f318647afb6

    “Currently, short-term health insurance makes up a tiny fraction of the policies sold, with fewer than 30 companies covering only about 160,000 people nationwide.” https://www.washingtonpost.com/national/health-science/trump-to-sign-executive-order-to-gut-aca-insurance-rules-and-undermine-marketplaces/2017/10/11/40abf774-ae97-11e7-9e58-e6288544af98_story.html?hpid=hp_no-name_no-name%3Apage%2Fbreaking-news-bar&tid=a_breakingnews&utm_term=.dfa6b2d3d5cf

  2. The Huckster is selling health care that has low premiums because it covers
    NOTHING ! It’s called Health care for all Americans, Coverage for none!
    At least the Majority of Americans didn’t vote for this Moron!

  3. Avatar for bdtex bdtex says:

    Might be time for Sen. Schumer and Rep. Pelosi to leave DJT hanging for awhile.

  4. TrumpDon’tCare…

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