Given the number of times Republicans have failed to repeal and/or replace the Affordable Care Act this year, it seems that President Trump is ready to unilaterally enact some executive orders aimed at weakening the health care law. Apparently the move is happening as a result of work between Senator Rand Paul and the President, who have been collaborating for months on the subject.
The New York Times reports on the upcoming changes to be unveiled today at the White House:
President Trump, after failing to repeal the Affordable Care Act in Congress, will act on his own to relax health care standards on small businesses that band together to buy health insurance and may take steps to allow the sale of other health plans that skirt the health law’s requirements.
The president plans to sign an executive order “to promote health care choice and competition” on Thursday at a White House event attended by small-business owners and others.
Although Mr. Trump has been telegraphing his intentions for more than a week, Democrats and some state regulators are now greeting the move with increasing alarm, calling it another attempt to undermine President Barack Obama’s signature health care law. They warn that by relaxing standards for so-called association health plans, Mr. Trump would create low-cost insurance options for the healthy, driving up costs for the sick and destabilizing insurance marketplaces created under the Affordable Care Act.
As noted, Trump has been saying these changes will be coming:
Since Congress can't get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people – FAST
— Donald J. Trump (@realDonaldTrump) October 10, 2017
Senator Paul echoed Trump’s sentiments as well:
— Senator Rand Paul (@RandPaul) October 10, 2017
So, what will these changes consist of? Nothing that comes close to repealing the law by executive order, more like minor tweaks, according to Rare:
Paul, who has advocated for a full repeal of Obamacare and the opening of an interstate insurance market, seems optimistic. Last month, the senator said he hoped Trump would move to reinterpret an existing law that prohibits consumers from purchasing insurance across state lines.
“I believe that President Trump can legalize on his own the ability of individuals to join a group or a health association across state lines and buy insurance,” he said. “If these individuals can join large groups across state lines, I think they’ll get protection, less expensive insurance, and it’ll be able to solve a lot of the problems we have in the individual market,” he added. [Emphasis added]
While the changes seem minimal, they could prove to be a destabilizing force to ObamaCare in the future, according to Politico:
Association health plans are already sold in some states but have to meet Obamacare’s regulations. If the administration were to free them from those rules, those plans could charge far lower premiums for a skimpier set of benefits — aiming to attract the healthiest and cheapest enrollees while potentially leaving Obamacare plans with higher-cost customers.
“It would deteriorate the risk pool, lead to increased premiums, more instability and potentially make insurers have to make decisions on whether they’re going to continue to participate,” said Cori Uccello, a senior health fellow at the American Academy of Actuaries.
The changes could be interpreted as a way for the President to further erode the law while loosening restrictions on it. This may force Republicans to continue trying to take up the issue, perhaps peeling away some Democrats if the Affordable Care Act becomes unworkable due to relaxed regulations.
The interesting part is that the President has been bashing Rand Paul in recent months for not signing on to any of the Senate repeal bills. However, reports indicate they speak frequently on the phone and have indeed worked on this for quite some time. Perhaps Rand sold it to Trump a way for the President to solely take a “win” on this issue while lashing out at the “do-nothing” congress.