Trump says executive order on health care alternatives will 'help millions of Americans'
The move allows the president to take action despite a stall in Congress in overhauling ObamaCare.
WASHINGTON (AP) -- President Donald Trump predicts “millions and millions of people” will benefit from his action to unwind the health care law.
He’s signed an executive order to make lower-premium plans more widely available.
But the changes Trump hopes to bring about could take months or even longer. That’s according to administration officials who outlined the order for reporters Thursday morning. The proposals may not be finalized in time to affect coverage for 2019, let alone next year.
White House domestic policy director Andrew Bremberg said that Trump still believes Congress needs to repeal and replace the Obama-era Affordable Care Act. The White House described the order as first steps.
Trump signed the order in the White House’s Roosevelt Room surrounded by Vice President Mike Pence, members of his Cabinet and Congress including Kentucky's U.S. Senator Rand Paul, who was given the pen the president used to sign the executive order.
Sen. Paul applauded Trump and the order saying in a statement that it will "increase competition and allow more Americans to join in groups to purchase lower-cost health insurance across state lines.
"Today's action is one of the most significant free market health care reforms in a generation and is a rare move by Washington to reduce government interference and provide more affordable health care options to everyday Americans. I applaud President Trump for following through on this action, which I have been working on with him for several months," said Dr. Paul.
Senate Majority Leader Mitch McConnell issued a statement saying the order will provide relief to Americans "suffering" under the Affordable Care Act. “Obamacare is failing and people across the country are hurting. I am pleased that the administration is looking for new ways to promote more affordable health insurance policies to better meet the needs of working families.”
The president says the order will provide what he calls “Obamacare relief” for millions of Americans. Trump is relying on the executive order because the Republican-controlled Congress has been unable to pass a plan to repeal and replace the Obama-era health care law.
Trump says the health care system “will get better” with his action, and the action will cost the federal government nothing.
The president says he still wants Congress repeal and replace the Obama health care law. But his says his order will give people more competition, more choices and lower premiums.
But Democrats in Congress like Kentucky 3rd District Representative John Yarmuth call the order "TrumpCare."
"With one signature, President Trump is now jeopardizing the health security of millions of Americans. The President's executive order calls for allowing insurance companies to build a huge market of junk plans, which will return us to the days where American families are one major illness or accident away from bankruptcy. Under these plans, insurers can deny coverage to people with pre-existing conditions, meaning only people who are currently healthy will buy them. The end result will be that costs for everyone else will soar, and ultimately, insurance markets that provide real coverage with real protections will collapse. Welcome to Trumpcare." -3rd District Representative John Yarmuth (D-Ky.)
Why it would take so long: The proposals have to go through the federal government's rule-making process, which involves public notice and comment, and that can take time.
Administration officials one of the main ideas is to ease the way for groups and associations of employers to sponsor coverage that can be marketed across the land. That reflects Trump's longstanding belief that interstate competition will lead to lower premiums for consumers who buy their own health insurance policies, as well as for small businesses.
Those "association health plans" could be shielded from some state and federal insurance requirements. But responding to concerns, the White House said participating employers could not exclude any workers from the plan, or charge more to those in poor health.
Other elements of the White House proposal include:
-Easing current restrictions on short-term policies that last less than a year, an option for people making a life transition, from recent college graduates to early retirees. Those policies are not subject to current federal and state rules that require standard benefits and other consumer protections.
-Allowing employers to set aside pre-tax dollars so workers can use the money to buy an individual health policy.
"This executive order is the start of a long process as the gears of the federal bureaucracy churn, not the final word," said Larry Levitt of the nonpartisan Kaiser Family Foundation.
It's also unlikely to reverse the trend of insurers exiting state markets. About half of U.S. counties will have only one "Obamacare" insurer next year, although it appears that no counties will be left without a carrier as was initially feared. White House officials said over time, the policies flowing from the president's order will give consumers more options.
Democrats are bracing for another effort by Trump to dismantle "Obamacare," this time with the rule-making powers of the executive branch. Staffers at the departments of Health and Human Services, Labor and Treasury have been working on the options since shortly after the president took office.
The president's move is also likely to encounter opposition from medical associations, consumer groups and perhaps even some insurers - the same coalition that so far has blocked congressional Republicans from repealing Obama's Affordable Care Act.
State attorneys general and state insurance regulators may try to block the administration in court, seeing the plan as a challenge to their traditional oversight authority.
As Trump himself once said, health care is complicated and working his will won't be as easy as signing a presidential order.
Experts say the executive order probably won't have much impact on premiums for 2018, which are expected to be sharply higher in many states for people buying their own policies.
Sponsors would have to be found to offer and market the new style association plans, and insurers would have to step up to design and administer them. For insurers, this would come at a time when much of the industry seems to have embraced the consumer protections required by the Obama health law.
Depending on the scope of regulations that flow from Trump's order, some experts say the alternatives the White House is promoting could draw healthy people away from "Obamacare" insurance markets, making them less viable for consumers and insurers alike
But conservatives such as Sen. Rand Paul believe the federal government has overstepped its bounds in regulating the private health insurance market. They argue that loosening federal rules would allow insurers to design plans that - although they may not cover as much - work perfectly well for many people.
About 17 million people buying individual health insurance policies are the main focus of Trump's order. Nearly 9 million of those consumers receive tax credits under the Obama law and are protected from higher premiums.
But those who get no subsidies are exposed to the full brunt of cost increases that could reach well into the double digits in many states next year. Many in this latter group are solid middle-class, including self-employed business people and early retirees. Cutting their premiums has been a longstanding political promise for Republicans.
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