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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 
fines.

   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 
insurance companies.

   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.


(KA)

 
 
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