Politics Foiled in Congress, Trump Signs Order to Undermine Obamacare

20:10  12 october  2017
20:10  12 october  2017 Source:   The New York Times

Foiled in Congress, Trump Moves on His Own to Undermine Obamacare

  Foiled in Congress, Trump Moves on His Own to Undermine Obamacare President Trump is expected to issue an order on Thursday to allow the sale of health insurance plans that are exempt from some Affordable Care Act rules.WASHINGTON — 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.

With the failure by Republicans in Congress to repeal Obamacare this year, President Trump is taking matters into his own hands, as he prepares to sign an executive order Thursday Congress has so far failed to repeal the ACA, but Trump still has considerable authority to undermine the law.

President Trump signed an executive order Thursday that could radically transform Obamacare and the American health care system in general, all without having to go through Congress .

President Trump signed an executive order on health care in the Roosevelt Room of the White House on Thursday. © Doug Mills/The New York Times President Trump signed an executive order on health care in the Roosevelt Room of the White House on Thursday.

WASHINGTON — President Trump signed an executive order on Thursday that clears the way for potentially sweeping changes in health insurance, including sales of cheaper policies with fewer benefits and fewer protections for consumers than those mandated under the Affordable Care Act.

But most of the changes will not come until federal agencies adopt regulations, after an opportunity for public comments — a process that could take months.

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Analysis | This executive order is Trump’s most significant step yet to undermine Obamacare

  Analysis | This executive order is Trump’s most significant step yet to undermine Obamacare By expanding the availability of plans that aren't regulated under Obamacare, Trump could send the Obamacare exchanges into a death spiral.Subscribe to the Post Most newsletter: Today’s most popular stories on The Washington Post

A few hours after taking the oath of office, President Donald Trump signed a sweeping executive order that encourages federal agencies to dismantle large parts of Obamacare , possibly including the hugely unpopular mandate requiring most Americans to purchase insurance. While only Congress can

Trump has repeatedly declared his desire to “let Obamacare fail ” and “let Obamacare explode.” Trump has said that he will sign an executive order to let people buy insurance through health associations. One expert referred to the policy as “repealing the ACA without Congress ,” while

“With these actions,” Mr. Trump said Thursday, “we are moving toward lower costs and more options in the health care market, and taking crucial steps toward saving the American people from the nightmare of Obamacare.”

“This is going to be something that millions and millions of people will be signing up for,” the president predicted, “and they’re going to be very happy. This will be great health care.”

The order resulted from Mr. Trump’s frustration with his inability to persuade a Republican-controlled Congress to repeal the Affordable Care Act, a pillar of President Barack Obama’s legacy. Supporters of the current health law called the order “sabotage,” a way to destroy the Affordable Care Act without winning a majority in Congress.

Experts Say Trump Order Could Upend Health Care System

  Experts Say Trump Order Could Upend Health Care System With Republican efforts to repeal Obamacare stalled, President Donald Trump issued a new executive order on Thursday that could undermine the law."Seven years ago, congressional Democrats broke the American healthcare system by forcing the Obamacare nightmare onto the American people. And it has been a nightmare," Trump said at the White House, adding that the order represented the first step "to providing millions of Americans with Obamacare relief.

Trump is expected to sign an executive order on Thursday directing an overhaul of major federal regulations that Trump ’s abuse of presidential power to undermine laws passed by Congress rather than “Having failed to replace Obamacare , I will try to make your premiums as high as possible!”

Republicans, despite controlling the White House and both chambers of Congress , have failed since Trump took office in January to make good on their seven-year promise to repeal Trump has taken a number of steps since assuming power in January to weaken or undermine Obamacare .

Mr. Trump directed three cabinet agencies to develop rules that would expand access to less expensive, less comprehensive insurance, including policies that could be sold by trade associations to their members and short-term medical coverage that could be offered by commercial insurers to individuals and families.

Many of the new insurance products could be exempt from requirements of the Affordable Care Act that Republicans say have contributed to sharp increases in premiums but that supporters say have created a baseline of care that has protected consumers from “junk insurance.”

Administration officials said they had not yet decided which federal and state rules would apply to the new products.

Mr. Trump’s order could eventually make it easier for small businesses to band together and buy insurance through new entities known as association health plans, which could be created by business and professional groups. A White House official said these health plans “could potentially allow American employers to form groups across state lines” — a goal championed by Mr. Trump and many other Republicans.

What You Need to Know About Trump’s Executive Order on Health Care

  What You Need to Know About Trump’s Executive Order on Health Care President Trump on Thursday took his biggest step yet toward accomplishing what Congress could not: dismantling the Affordable Care Act. Saying he was starting the process of Obamacare repeal, Trump signed an executive order that he and his allies say will provide more options and lower costs in the health care market. Saying he was starting the process of Obamacare repeal, Trump signed an executive order that he and his allies say will provide more options and lower costs in the health care market. “We are going to also pressure Congress very strongly to finish the repeal and the replace of Obamacare once and for all,” the president added.

President Trump issued an order on Thursday to allow the sale of health insurance plans that are exempt from some Affordable Care Act coverage rules. The New York Times. Politics|Foiled in Congress , Trump Signs Order to Undermine Obamacare .

Trump , who has called the law a failure and vowed to let it "implode," has undermined Obamacare President Donald Trump said on Tuesday he likely will sign an order this week that is expected to “With Congress the way it is, I decided to take it upon myself,” Trump added, saying the plan is

The action on Thursday followed the pattern of previous policy shifts that originated with similar directives from the president. Within hours of his inauguration in January, Mr. Trump ordered federal agencies to find ways to waive or defer any provisions of the Affordable Care Act that might burden consumers, insurers or health care providers. In May, he directed officials to help people with religious objections to the federal mandate for insurance coverage of contraception.

Both of those orders were followed up with specific, substantive regulations.

In a summary of the new executive order, the White House said that a broader interpretation of federal law — the Employee Retirement Income Security Act of 1974 — “could potentially allow employers in the same line of business anywhere in the country to join together to offer health care coverage to their employees.” As a result, it said, “workers could have access to a broader range of insurance options at lower rates in the large group market.”

A White House official said that “employers participating in an association health plan cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions” of individual employees.

Trump to cut off key ObamaCare payments: report

  Trump to cut off key ObamaCare payments: report President Trump plans to cut off key payments to insurers selling ObamaCare coverage, Politico reported Thursday, citing two sources familiar with the matter.Such an action would represent Trump's most aggressive move yet to dismantle ObamaCare, after GOP efforts to repeal and replace the health-care law failed this year.Trump has repeatedly threatened to cut off the disbursements to insurers, known as Cost Sharing Reduction (CSR) payments. They are worth an estimated $7 billion this year, Politico noted.

Stymied in Congress by the failure of Senate Republicans to roll back former President Barack Obama 's 2010 healthcare law, Trump 's executive order would represent his administration's latest effort to undermine the law donald trump . executive order , obamacare , health insruance. 449.

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But state officials pointed out that an association health plan can set different rates for different employers, so that a company with older, sicker workers might have to pay much more than a firm with young, healthy employees.

“Two employers in an association can be charged very different rates, based on the medical claims filed by their employees,” said Mike Kreidler, the state insurance commissioner in Washington.

Mr. Trump also directed the secretaries of the Treasury, labor and health and human services to find ways of expanding access to “short-term limited duration insurance.” And the White House said that such insurance “is not subject to costly Obamacare mandates and rules.”

Short-term policies could be particularly useful to people in counties where only a single insurer is offering plans in the Affordable Care Act marketplace, the White House said.

“In 2018,” it said, “more than 1,500 counties — nearly 50 percent of all counties — are projected to have only one option on their individual insurance exchanges.”

But short-term policies can limit benefits and charge higher premiums to people who have expensive medical conditions, a type of discrimination banned in policies regulated under the Affordable Care Act.

Trump to halt 'massive' ObamaCare subsidies; legal fight likely

  Trump to halt 'massive' ObamaCare subsidies; legal fight likely President Trump plans to halt payments to insurers under the Affordable Care Act "immediately," in a major blow to ObamaCare that is likely to draw a legal challenge.  The president, though, used the overnight decision to up pressure on Democrats to negotiate a "fix" to the "imploding" health care law. "The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!" he said in a pre-dawn tweet on Friday.

President Trump is pressuring Congress to sink parts of the Affordable Care Act. But now that the first attempt at a GOP health- care overhaul has failed , he must decide whether to throw the law a line. The White House and Republican lawmakers are facing key decisions that could either improve the

Trump spews anti-First Amendment rant: ‘It is frankly disgusting the press is able to write whatever it wants’. Trump order to undermine Obamacare Despite controlling the White House and Congress , Republicans have failed in efforts this year to fulfill their campaign promise to repeal and replace

Another part of Mr. Trump’s order indicates that he may wish to crack down on the consolidation of doctors, hospitals and other health care providers, a trend that critics say has driven up costs for consumers. Mr. Trump said that administration officials, working with the Federal Trade Commission, should report to him within 180 days on federal and state policies that limit competition and choice in the health care industry.

GOP Rep. breaks with Trump: Cutting health care subsidies does 'opposite' of what he promised

  GOP Rep. breaks with Trump: Cutting health care subsidies does 'opposite' of what he promised A Republican lawmaker slammed President Trump's action on health care Friday.Rep. Ileana Ros-Lehtinen (R-Fla.) said that cutting key payments to ObamaCare insurers will mean more of her constituents will be uninsured.

President Donald Trump signed an executive order on Thursday to weaken the Obamacare law Republicans, despite controlling the White House and both chambers of Congress , have failed Trump has taken a number of other steps since January to weaken or undermine Obamacare .

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In battles over the Affordable Care Act this year, Mr. Trump and Senate Republicans said they wanted to give state officials vast new power to regulate insurance because state officials were wiser than federal officials and better understood local needs. But under the executive order, the federal government could pre-empt many state insurance rules, a prospect that alarms state insurance commissioners.

Mr. Trump’s initiative is supported by business groups that see association health plans as a possible way to provide more affordable health insurance to their members. These include the National Federation of Independent Business, the National Association of Wholesaler-Distributors and the National Restaurant Association.

But consumer groups and the National Association of Insurance Commissioners, representing state officials, have opposed association health plans because they could be largely exempt from state regulation.

Association health plans “cherry-pick health groups,” making it more difficult for less healthy groups to find affordable coverage, the National Association of Insurance Commissioners told Congress this year.

Some state regulators and insurers greeted the move with alarm and warned that by relaxing standards for association health plans and short-term policies, 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.

Frustrated By Congress, Trump Pursues His Agenda Through Executive Action

  Frustrated By Congress, Trump Pursues His Agenda Through Executive Action 'So we’re going a little different route'Big ticket legislative items like tax reform, infrastructure investments and health-care reform have yet to be accomplished, and Trump’s most significant actions have been through executive order.

In the wake of Congress ’ failure to repeal and replace Obamacare with an even shittier system, the White House has ramped up efforts to undermine existing health insurance markets in order to build Sign Up. More on Death and Taxes. Trump 's golf course left Puerto Rico million in debt.

“By siphoning off healthy individuals, these junk plans could cannibalize the insurance exchanges,” said Topher Spiro, a vice president of the Center for American Progress, a liberal research and advocacy group. “For older, sicker people left behind in plans regulated under the Affordable Care Act, premiums could increase.”

But to business groups, the executive order offers an opportunity to bind their members together and sell large-group insurance policies that are cheap and attractive. Dirk Van Dongen, the president of the National Association of Wholesaler-Distributors, said that he was delighted with Mr. Trump’s initiative and that his group would seriously consider establishing an association health plan.

“Small to midsize businesses have very little leverage in the insurance market,” Mr. Van Dongen said. “Anything that allows them to amalgamate their purchasing power will be helpful.”

Large employer-sponsored health plans are generally subject to fewer federal insurance requirements than small group plans and coverage purchased by individuals and families on their own. They are generally not required to provide “essential health benefits,” such as emergency services, maternity and newborn care, mental health coverage and substance abuse treatment, although many do.

A decision by Obama appointees in 2011 discouraged the use of association health plans as a substitute for Affordable Care Act policies because officials feared they would be used to circumvent the law’s coverage mandates. The Obama administration said that coverage offered to dozens or hundreds of small businesses through a trade or professional association would not be treated as a single large employer health plan for the purpose of insurance regulation.

Instead, the Obama administration said, the government would look at the size of each business participating in the association, so that many small employers would still be subject to stringent federal rules.

The Trump administration now wants to make it easier for small businesses to buy less expensive plans that do not comply with some requirements of the 2010 law.

Large-group plans are still subject to some requirements of the Affordable Care Act. They generally must cover children up to age 26 on their parents’ plans, cannot impose lifetime limits on covered benefits and cannot charge co-payments for preventive services like mammograms and colonoscopies.

But they are generally exempt from the requirements to provide a specified package of benefits and to cover a certain percentage of the cost of covered services.

The Trump administration is also looking for ways to ease restrictions on short-term health insurance plans that do not meet requirements of the Affordable Care Act. Under a rule issued last October by the Obama administration, the duration of such short-term plans, purchased by hundreds of thousands of people seeking inexpensive insurance, must be less than three months. The rules previously said “less than 12 months.”

The Obama administration said some insurers were abusing short-term plans and keeping healthier consumers out of the Affordable Care Act marketplaces. People are buying these short-term plans as their “primary form of health coverage,” and some insurers are pitching the products to healthier people, the Obama administration said.

But the U.S. Chamber of Commerce said short-term policies “serve an important purpose for consumers” who are between jobs.

The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.

People who want or need broad coverage could find it increasingly difficult to obtain an affordable policy, experts say. While the administration’s goal may be to give people a broader choice of plans, it could have the opposite effect on people who need or want the robust coverage available under the Affordable Care Act.

“The easier you make it not to buy comprehensive coverage, the harder you make it to buy comprehensive coverage,” said Katherine Hempstead, a health policy expert at the Robert Wood Johnson Foundation.

Insurers still on the Affordable Care Act’s online marketplace are most jittery about the possibility of a surge in short-term plans. Many of the large national insurers, like UnitedHealth Group, already offer these plans, and there would be little difficulty in their introducing more because of the executive order, analysts said.

“They can cobble these things together pretty easily,” said John Graves, a health policy expert at Vanderbilt University.

Individuals may already be attracted to short-term plans because of their low costs. These plans tend to limit benefits or offer policies only to people who do not have expensive medical conditions.

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Frustrated By Congress, Trump Pursues His Agenda Through Executive Action .
'So we’re going a little different route'Big ticket legislative items like tax reform, infrastructure investments and health-care reform have yet to be accomplished, and Trump’s most significant actions have been through executive order.

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