Trump Moves to Administratively Change the ACA

While Congress could not legislatively repeal or even modify the Affordable Care Act ("ACA"), President Trump is moving to make significant changes in it administratively through the executive power.  The Executive Order issued on October 12, 2017 instructs federal agencies to lay the groundwork for allowing less-expensive insurance plans with fewer benefits under certain circumstances, and to foster competition in the individual insurance markets. 

While the previous administration had allowed certain short-term insurance to provide limited coverage, the limits will be lifted under the programs envisioned by the Executive Order and will seek to expand ways in which workers can use employer-funded accounts to buy their own policies.  Plans may also be developed to let small businesses and possibly individuals ban together to buy insurance that is cheaper but less extensive.  The new health plan concepts would not be subject to as many restrictions.  Other possible executive action changes have been announced that would include the discontinuance or reduction in certain health care subsidies that were not a part of the ACA, but that the Obama Administration nevertheless funded without Congressional approval.  A federal district court judge had ruled that the subsidies were illegal but did not enjoin them.  At the same time, the Trump Administration is considering certain legislative proposals that would preserve the payments to insurers while allowing for an Administration proposal to give states more flexibility in implementing the ACA.  As this newsletter is going to press, reports indicate that a bipartisan group of senators are close to an agreement to preserve for two years the insurance subsidy payments made to help offset consumers’ out-of-pocket costs, while allowing flexible new provisions enabling more people to buy less comprehensive plans with higher deductibles but lower premiums, and also making it easier for states to get waivers from the ACA requirements.