President Trump on Thursday signed an executive order aimed at taking action on ObamaCare on his own after Congress failed to repeal the law.
Administration officials said the order is just the beginning of the administration’s actions related to the health law.
The full extent of the changes will not be immediately clear. The executive order largely does not make changes itself, rather it directs agencies to issue new regulations or guidance. Those new rules will go through a notice and comment period that could take months, officials said.
Experts warned that the order could undermine the stability of ObamaCare markets by opening up skimpier, cheaper plans that would divert healthy people away from ObamaCare plans.
Democrats warn that the order is part of Trump’s larger plan to “sabotage” the health law and accomplish on his own what Congress could not.
Trump said Thursday the order is "starting that process" to repeal ObamaCare. It will be the "first steps to providing millions of Americans with ObamaCare relief," Trump said.
Trump’s order seeks to expand the ability of small businesses and other groups to band together to buy health insurance through what are known as association health plans (AHPs). It also lifts limits on short-term health insurance plans.
Because both of these types of plans do not have to follow the same ObamaCare rules, such as covering certain benefits, experts warn that healthier people could join these cheaper plans and leave only sicker people in ObamaCare plans. That could lead to a spike in premiums for ObamaCare plans or insurers simply dropping out of the market.
The move is a victory for Sen. Rand Paul (R-Ky.), who has long pushed for expanding association health plans, saying they give people choices for lower-cost coverage. He joined Trump at the White House on Thursday, calling the move the “biggest free market reform of health care in a generation.”
“This executive order is good for healthy people (while they're healthy) and bad for sick people,” Larry Levitt, a health care policy expert at the Kaiser Family Foundation, wrote on Twitter. “Only question is the extent of the effect.”
Democrats have already been crying foul about administration cutbacks to outreach for the coming ObamaCare enrollment period, which begins Nov. 1, including a 90 percent cut to the advertising budget.
The order does not address whether individuals can join association health plans, which would make the order more broad and have deeper effects on the ObamaCare market.
However, officials have only discussed the change in the context of small businesses, and a senior administration official said “some employer-employee relationship must be present” for someone to join. Officials do say that small employers in the same “line of business” anywhere in the country could join together.
It does not address whether people in the short-term or association plans would still have to a penalty for lacking insurance. But an official said that “presumably,” at least for the association health plans, people would not have to pay the penalty.
The order will also allow people to use tax-advantaged accounts known as health reimbursement accounts to pay for their premiums.