Exec. Order First Strike on Obamacare 01/21 10:00
In an opening salvo against "Obamacare," President Donald Trump signed an
executive order Friday night that appears aimed squarely at undoing the
unpopular requirement that individuals carry insurance or face fines.
WASHINGTON (AP) -- In an opening salvo against "Obamacare," President Donald
Trump signed an executive order Friday night that appears aimed squarely at
undoing the unpopular requirement that individuals carry insurance or face
The order directs federal agencies to stop issuing regulations that would
expand the law's reach. And it directs them to grant waivers, exemptions and
delays of provisions in the Affordable Care Act that would impose costs on
states or individuals, potentially including the law's penalties on people who
remain uninsured --- a key provision. The order also says federal agencies must
allow states greater flexibility in carrying out the health care programs.
"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 nonpartisan clearinghouse for information and analysis about the
health care system.
It may take weeks or months to discern the full impact of Trump's directive
on "Obamacare." Departments like Health and Human Services and Treasury will
have to issue policies that embody the new president's wishes.
One distinct possibility is for the government to find new ways to grant
exemptions from the law's unpopular requirement that people who remain
uninsured pay fines, if deemed able to afford coverage. For example, GOP
lawmakers in Congress have proposed an exemption for people in areas where only
one insurer offers coverage --- currently about a third of U.S. counties.
The executive order may not have much impact for 2017, since government
rules for this year have already been incorporated into contracts signed with
But Levitt said broad exemptions from the law's coverage requirement could
scare off insurers already on the fence about continuing to participate in 2018
and beyond. Insurers see the law's coverage requirement, or so-called
individual mandate, 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.
Leslie Dach, campaign director of the Protect Our Care Coalition, issued a
statement saying, "While President Trump may have promised a smooth transition,
the Executive Order does the opposite, threatening disruption for health
providers and patients." He called the executive order "irresponsible."
Trump made clear he is not unilaterally suspending the Affordable Care Act.
It remains on the books, and his directive instructs agencies to act within
"the maximum extent permitted by law."
Changing the underlying law would require Congress to act, but the Trump
administration can rewrite regulations carrying out the legislation. New
regulations cannot be issued overnight, but would have to follow a legally
established process that requires public notice and an opportunity for
interested parties to comment on the administration's changes.