Trump signs health care executive order

The executive order allows businesses to band together to buy medical insurance more cheaply even across state lines

President Donald Trump on Thursday signed an executive order that allows small businesses to band together and buy health insurance that flouts Affordable Care Act (ACA) regulations.

"It directs the Department of Health and Human Services, the Treasury, and the Department of Labor to take action to increase competition, increase choice, and increase access to lower-priced, high-quality health care options", Trump said.

However, it could also destabilize Obamacare by siphoning out younger and healthier Americans from the exchanges.

"I don't know that it accomplishes all that much" in the short-term, said Gary Claxton, a vice president at the Kaiser Family Foundation, a leading health-care policy research group, when asked about the impact of the order.

"This is going to be something that millions and millions of people will be signing up for", the president said, "and they're going to be very happy".

"It should have been done a long time ago, and it could have been done a long time ago", lamented Trump.

Officials pointed out that they expect that half of the counties in the United States will have just one insurer offering Obamacare individual health plans next year, up from one-third of such counties this year. They also could be subject to limits on annual and lifetime costs, and people with pre-existing conditions could be charged more for their coverage.

The executive order aims to make lower-premium health care plans available to more Americans.

Trump's signature to the new executive order comes less than three weeks before the November 1 start to the open-enrollment sign-up season for Obamacare.

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His latest executive order, signed Thursday, will cause premiums to fall drastically for "millions of Americans", Trump said.

Sen. Rand Paul and Vice President Mike Pence both spoke at the signing.

One quirk of the new executive order is that in order to allow businesses to form their own associations, Trump is not altering the Affordable Care Act but rather another law altogether - the Employment Retirement Income Security Act of 1974, known as ERISA.

Trump's efforts with congressional Republicans to repeal and replace the Affordable Care Act have floundered after analyses of the GOP replacement plans showed the number of Americans without insurance would increase by more than 20 million people, as compared to current law. If a business has enough employees that require expensive health care, premiums for everyone in that workplace could be jacked up.

"Having failed to repeal the #ACA in Congress, @POTUS is using a wrecking ball to singlehandedly rip apart & sabotage our healthcare system", Senate Minority Leader Chuck Schumer, D-New York, tweeted.

Claxton said if the administration ends up loosening enforcement of the Obamacare coverage mandate, "it could be disruptive, and it could happen very quickly".

Association health plans, which are usually sponsored by trade organizations or interest groups, already exist.

Meanwhile, on Wednesday, Covered California said it will ask insurers to add surcharges to some policies in 2018, because the Trump administration hasn't pledged yet to pay certain ACA consumer subsidies. Instead, the nationwide plans may come under the same federal oversight as large-employer policies.

Levitt said association health plans and short-term health insurance policies could be designed to lure healthier people away from the state insurance markets created by the Obama health law. Silver-level health plans will face a total premium jump of about 25 percent.

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