Trump makes end run on health rules
Frustrated by failures in Congress, he tries to put own stamp on care
WASHINGTON — Frustrated over setbacks in Congress, President Donald Trump wielded his rule-making power Thursday to launch an end run that might get him closer to his goal of repealing and replacing “Obamacare.”
Whether Trump’s executive order will do the trick isn’t clear.
Experts say consumers aren’t likely to see major changes anytime soon, although the White House is promising lower costs and more options.
Some experts warned that hard-won protections for older adults and people in poor health could be undermined by the skinny lower-premium plans that Trump ordered federal agencies to facilitate.
Others say the president’s plans will have a modest impact, and might even help some consumers who don’t benefit from financial assistance under the Obama-era Affordable Care Act.
People on different sides of the polarized debate did agree that it will take months for the bureaucracy to turn Trump’s broad-brush goals into actual policies that affect millions of people who buy their own health insurance policies.
“Today is only the beginning,” Trump said at the Oval Office signing ceremony. He promised new measures in coming months, adding, “We’re going to also pressure Congress very strongly to finish the repeal and replace of Obamacare once and for all.”
One of the main ideas from the administration involves easing the way for groups of employers to sponsor coverage that can be marketed across the country. That reflects Trump’s long-standing belief that competition across state lines will lead to lower premiums.
Those “association health plans” could be shielded from some state and federal insurance requirements. 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. Selfemployed people might be able to join.
Other elements of the White House plan include:
Easing current restrictions on 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 pretax dollars so workers can use the money to buy an individual health policy.
“This could be much ado about nothing, or a very big deal, depending on how the regulations get written,” said Larry Levitt of the nonpartisan Kaiser Family Foundation. “The intent of the executive order is clear, to deregulate the insurance market. ... It’s unclear how far the administration will ultimately go.”
Late Thursday, the White House confirmed that it would end critical payments to health insurers that help millions of lower-income Americans afford coverage, although a statement did not specify when. According to two people briefed on the decision, the cutoff will be as of November. The subsidies total about $7 billion this year.
Trump has threatened for months to stop the payments, but held off while other administration officials warned him that such a move would cause an implosion of the ACA marketplaces that could be blamed on Republicans.
Ending the payments is grounds for any insurer to back out of its federal contract to sell health plans for 2018.