After several failed legislative attempts to repeal and replace the Affordable Care Act (ACA), President Donald 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, which could allow American employers to form groups across state lines. The 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—to make the move happen.
The EO also directs the U.S. Treasury Department, the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) to consider expanding coverage through low-cost, short-term limited duration insurance by rolling back certain ACA restrictions. Finally, the EO directs the departments to consider changes to health reimbursement arrangements.
The proposed changes could undermine the ACA insurance markets by drawing younger, healthier people away from more comprehensive—and more expensive—marketplace plans, leaving sicker (and costlier) patients behind. Cost increases to ACA plans would likely follow.