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Trump signs executive order relaxing some Obamacare rules

President Donald Trump this morning signed an executive order aiming to give consumers access to cheaper, skimpier health plans by easing some policy restrictions under the Affordable Care Act.

The order directs the Departments of Treasury, Labor, and HHS to consider expanding coverage through low-cost, short-term health plans that are exempt from Affordable Care Act insurance market rules.

Such plans presumably would not have to comply with ACA requirements that plans cover 10 categories of minimum essential benefits or accept all applicants at the same rates without regard to pre-existing medical conditions.

The order apparently would allow individuals to buy such short-term plans lasting up to 364 days. Obama administration rules limited the duration of short-term plans to 90 days.

The order also directs the Secretary of Labor to consider expanding access to so-called association health plans, potentially allowing employers to band together in health plans crossing state lines.

The order apparently would not allow these expanded association plans to market to individuals, which many observers had expected the White House to do.

Health policy experts warned Trump’s order, depending on how it’s implemented by federal agencies, could drive up premiums and make coverage less available for people who are older and who have pre-existing health conditions. That’s because healthier customers likely would move into the cheaper, leaner plans, prompting insurers to raise rates for more comprehensive plans or exit the market entirely.

Under Trump’s order, short-term plans and the association plans might not have to comply with ACA requirements that plans cover 10 categories of minimum essential benefits or accept all applicants at the same rates without regard to preexisting medical conditions.

The White House said the goal was to offer more affordable coverage to people if they band together through business and occupational associations to get plans. “Private insurers are going to give you incredible health care,” Trump told truckers in Pennsylvania Wednesday.

“Our members are clamoring for more options, and association health plans are certainly one way to get that option,” said Kevin Kuhlman, director of government relations at the National Federation of Independent Business.

But many insurance leaders, state regulators, and policy experts fear that Trump’s order could drive up premiums and make coverage less available in the regulated individual market, which people who need comprehensive benefits depend on.

“Association plans exempt from the ACA can cherrypick healthy people and make coverage unaffordable for those with pre-existing conditions,” tweeted Larry Levitt, a senior vice president at the Kaiser Family Foundation. “Insurers will leave the ACA marketplaces as soon as they can or hike premiums a lot.”

Health law experts questioned whether Trump’s executive order easing the ACA’s statutory insurance market rules would withstand legal scrutiny, and predicted legal challenges.

“Many commentators including me think the law should be changed to foster competition across state lines,” said Stuart Gerson, a former top Justice Department official in the George H.W. Bush and Clinton administrations who’s now a partner at Epstein Becker & Green. “But I don’t think you can solve this problem without changing the law. It has to be done by statute, not regulation.”

Read the full story at Modern Healthcare: Trump signs executive order to relax health insurance rules – Modern Healthcare


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