President Donald Trump is scheduled to sign an executive order Thursday to expand health insurance options for some Americans, in a move that may also undermine coverage for those who remain in Obamacare.
The order would direct federal agencies to take several actions through federal rule-making. Small employers would potentially be able to band together from across the country to create “association health plans” and buy insurance together outside of Obamacare. The order will also call for expanding the availability of low-cost, limited, short-term insurance plans, as well as the use of tax-advantaged accounts to pay for health-care expenses.
“The policies outlined in the executive order are the beginning of the actions the administration will take to provide relief to people harmed by Obamacare,” said Andrew Bremberg, director of the administration’s domestic policy council. “You should expect additional actions coming from the administration in months to come.”
Critics have said that such actions will end up pulling healthier people out of Obamacare’s existing markets, which have strict requirements on what services have to be covered, such as maternity or mental health coverage. The result would be fewer people in the Affordable Care Act’s markets, and the ones who remained could be sicker -- driving up premiums, and forcing more people to look elsewhere for coverage.
“It would essentially create a parallel regulatory structure within the individual and small group markets that is freed from the various consumer protections established,” said Spencer Perlman, a policy analyst with Veda Partners, a Bethesda, Maryland-based advisory firm. “The end result could be a death spiral for ACA-compliant plans.”
More Limited?
The administration order on association plans is focused on businesses, however, not individuals -- meaning it could have a more limited effect in terms of how many people would take advantage of it. According to a summary of the executive order distributed before the planned signing, employers in an association plan “cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions.”
The order comes on the heels of Republicans’ failed attempts to repeal the Affordable Care Act. It would likely require new regulations, meaning that the plans the order is expected to encourage wouldn’t be available until any new rules are in place.
Trump is scheduled to sign the order at the White House at 11:15 a.m. On Tuesday, he said tweeted, “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.”
The short-term plans would create another option outside of the ACA, allowing people to buy low-cost, temporary plans, instead of more comprehensive, longer-term coverage, according to the summary. Such plans would not be “subject to costly Obamacare mandates and rules,” according to the summary, and would be used by people in between jobs or who didn’t like the options they had under Obamacare.