Trump’s First Action Is Against Affordable Care Act

Donald Trump had been in office only hours when, on January 20, he signed an executive order in a first strike against the Affordable Care Act. According to a writer for Modern Healthcare, the order directs federal agencies to stop issuing regulations that would expand the law’s reach. It directs agencies to grant waivers, exemptions and delays of provisions in the Act that would impose costs on states or individuals, including the law’s penalties on people who remain uninsured. “It’s a sign that the Trump administration is looking to unwind the law in every way it can administratively, ” said Larry Levitt of the Kaiser Family Foundation, a clearinghouse for information and analysis about the healthcare system.

Since departments like Health and Human Services and Treasury must devise policies that carry out the president’s wishes, it may take months to define the impact of Trump’s directive. Government rules for this year have already been incorporated into contracts signed with insurance companies, so the executive order may not have much impact in 2017.

Levitt said broad exemptions from the law’s coverage requirement could scare off insurers about continuing to participate in 2018 and beyond. Insurers see the law’s coverage requirement as an essential tool to nudge healthy people into the coverage pool. Without it the companies and most independent experts believe premiums would spike, making HealthCare.gov’s insurance markets unsustainable.

“It would create a significant amount of uncertainty and affect insurers’ ability to participate for 2018, ” Levitt said.