Trump order weakens Obamacare
WASHINGTON — With a Republican-controlled Congress unable to repeal Obamacare, President Donald Trump is moving forward on other options that he hopes will unravel the Affordable Care Act.
“If the Senate can’t provide Americans with relief, then I’ll take matters into my own hands,” he said in a fundraising missive to supporters shortly after signing an executive order Thursday in the White House.
Trump threw a bomb into the marketplaces by saying he’ll end critical payments
to the health insurers that help millions of lower-income Americans afford coverage.
The White House confirmed late Thursday that it would halt federal payments for costsharing reductions, 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, which help eligible consumers afford their deductibles and other out-of-pocket expenses, 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.
Trump also directed his administration to consider expanding access to low-cost, short-term insurance not subject to Obamacare requirements such as the mandate to cover essential health benefits — including hospitalization, prescription drugs, maternity care and substance-abuse treatment — or regulations that require insurance companies to cover people regardless of their medical history.
Trump’s administration argues that loosening such restrictions would create far cheaper options for those seeking insurance.
His executive order also relaxes regulations on association health plans, which allow small-employer groups and individuals to band together to buy health insurance. The expansion of such plans could allow U.S. employers to form insurance groups across state
lines, which Republicans say would lower costs.
Finally, the order directs Trump’s Cabinet to consider expanding access to Health Reimbursement Arrangements — tax-free, employer-funded accounts reimbursing employees for health-care expenses.
“With these actions, we are moving toward lower costs and more options in the health-care market and taking crucial steps towards saving the American people from the nightmare of Obamacare,” Trump said in a ceremony where he was flanked by lawmakers, Vice President Mike Pence and other supporters.
Trump said his actions will cost the federal government “virtually nothing, and people will have great, great health care.”
Larry Levitt, a senior vice president for the Kaiser Family Foundation, tweeted: “President Trump’s executive order aspires to do a lot. If it fulfills its aspirations, it would undermine (Obamacare) significantly. A big if.”
Levitt also wrote, “Likely losers with the executive order: People with pre-existing conditions. Winners: Healthy people (and their small employers), lawyers.”
People on different sides of the polarized debate did agree that it will take months for the federal bureaucracy to turn Trump’s broad-brush goals into actual policies.
To supporters, Trump’s order opens new insurance alternatives at potentially lower prices, helping to follow through on a campaign promise to undo Obamacare that Republicans have made since the law was passed in 2010.
To detractors, the move was repeatedly described with one word: Sabotage.
“Instead of employing
backdoor tactics meant to undermine important healthcare protections, President Trump should come to the table with members of both parties to pursue meaningful health-care reform that benefits Ohioans,” said Sen. Sherrod Brown, D–Ohio.
Brown argued that the expanded association plans would limit access to such benefits as maternity services and emergency care and destabilize the Obamacare market by flooding the insurance market with skimpier plans.
Brown and others — including Ohio Gov. John Kasich — had argued for a bipartisan solution to shoring up the Obamacare markets. Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander, R-Tenn., engaged in bipartisan talks that were thwarted by GOP Senate leaders.
U.S. Rep. Tim Ryan, D-Niles, was especially critical of Trump’s actions.
“Since he first announced his campaign for the presidency, I’ve heard President Trump falsely claim dozens of times that the Affordable Care Act was collapsing. Today, I am in disbelief that the president would so blatantly sabotage America’s healthcare system in order to make that falsehood a reality. His executive order will create a loophole that would allow insurers to sell watered-down insurance plans that do not cover essential health benefits like pregnancy coverage, mental-health care, and cancer screenings. It dismantles coverage protections for people with pre-existing conditions and further disadvantages the sick and middle class.”
While Democrats decried Trump’s action, Republicans
such as Rep. Jim Jordan, R-Urbana, said Trump was “doing what voters sent him here to do.”
“Today’s executive order on health care will start to give everyday Americans the relief they need from soaring premiums,” Jordan said, while calling on Congress to fully repeal Obamacare.
“Obamacare added a tangled mess of bureaucracy, mandates and regulations to our health-care system,” said Rep. Pat Tiberi, R-Genoa Township, adding that those on the Obamacare exchanges have been paying more for lower quality care.
“The president is taking a necessary step by instructing his administration to do what they can under current law to restore the free market, lower costs and improve access to quality care.”
On Thursday, Ohio’s Democratic House delegation — Reps. Joyce Beatty of Jefferson Township, Marcia Fudge of Cleveland, Marcy Kaptur of Toledo and Ryan — sent a letter to Center for Medicare and Medicaid Services Administrator Seema Verma complaining about cuts in services and outreach programs designed to enroll citizens in Obamacare.
“Individuals will now be without the help they need to enroll in health-care plans even though every American is required to have health insurance under current law and face tax consequences if they fail to obtain coverage,” the group wrote.