After several failed legislative attempts to repeal and replace the Affordable Care Act (ACA), President Trump is now taking matters into his own hands.
On October 12, Trump signed a new Executive Order (EO) designed to “expand choices and alternatives to Obamacare plans and increase competition to bring down costs for consumers,” according to a White House press release.
The EO directs the Secretary of Labor to consider expanding access to Association Health Plans (AHPs), which could potentially allow American employers to form groups across state lines; such plans would be exempt from many of the requirements imposed by the ACA. The Employee Retirement Income Security Act (ERISA) would need to be changed—or interpreted more broadly—in order to make this happen.
The EO also directs the Departments of the Treasury, Labor, and Health and Human Services to consider expanding coverage through low cost short-term limited duration insurance (STLDI) by rolling back certain ACA restrictions.
Finally, the EO directs the Departments of the Treasury, Labor, and Health and Human Services to consider changes to Health Reimbursement Arrangements (HRAs).
The proposed changes could undermine the ACA insurance markets by drawing younger, healthier people away from the more comprehensive—and more expensive—marketplace plans, leaving sicker (and costlier) patients behind; cost increases to the ACA plans would likely follow.