Trump Signs Health Care Executive Order, Here’s What It Really Means

Update: Thursday, Oct. 12

Trump has just signed an executive order on health care. Here are the main bullet points (via Bloomberg):

  • President Trump issues executive order expanding lower-cost “association health plans,” as well as low-cost, shorter-term plans outside of the 2010 Affordable Care Act.
  • Trump also directs federal govt to expand tax-free “Health Reimbursement Arrangements,” employer-funded, tax-advantaged accounts used to help workers pay for health-care costs
  • Govt also should consider expanding coverage through short-term limited duration insurance, or STLDI, which is exempt from Obamacare mandates and rules, according to fact sheet on order

And here’s the photo op:

We detailed this over the weekend, and if you missed that post, you need to at least skim it because needless to say, Trump is peddling what, at best, is a disingenuous line.

Below, find the details…

Background, from our Sunday post

Ok, well just hours after Trump confirmed that he called Chuck Schumer in an attempt to revive efforts to build consensus around healthcare reform, WSJ is out reporting that the President will sign an executive order next week that will roll back some ACA rules.

This isn’t unexpected. It was generally seen as the next move after the GOP’s last effort to “repeal and replace” crashed and burned. “It’s being finished now,” Trump said last month following the Graham-Cassidy debacle. “It’s going to cover a lot of territory and a lot of people. Millions of people,” Trump added, slapping a couple of his trademark superlatives on another nebulous promise.

Basically, this order is going to do three things. First, Trump is going to order the Departments of Health and Human Services, Labor and Treasury, to free people up to go the “association health plans,” route. These won’t have to cover a set package of benefits and the criticism is that invariably, they’ll “peel off healthier and younger individuals and leave traditional insurance plans to cover sicker and older customers.”

Second, Trump will apparently lift the ban on “short-term medical insurance,” and finally, third, WSJ says the President “will order agencies to expand health reimbursement accounts, employer-funded arrangements that employees can use to pay out-of-pocket medical costs and premiums.”

What does all of that mean? Well, who knows, really – certainly not Trump. As usual, he’s just doing what someone else has told him will play well with Conservatives.

One thing that seems clear is that the association health plan bit, by virtue of what it means for the prospect of selling insurance across state lines, could imperil any future effort to build broad-based support for a more comprehensive fix.

Additionally, this seems fraught with legal peril. Consider these excerpts from a Politico piece published late last month after Trump hinted that an executive order was coming:

Trump didn’t elaborate on how he would allow insurance to be sold across state lines. But most insurance experts find it hard to imagine how an executive order could supplant existing state regulations, and believe such a move would likely spark a legal challenge.

“Health insurers already have the ability to sell insurance in multiple states as long as they comply with state consumer protection and licensing laws, which many already do,” said Mike Consedine, CEO of the National Association of Insurance Commissioners, in a statement to POLITICO. “The NAIC has long been opposed to any attempt to reduce or preempt state authority or weaken consumer protections.”

Several states — including Wyoming, Maine and Georgia — have already tried allowing across-state sales, and it’s been a colossal bust. The chief reason: There’s been zero interest from insurers. That’s in part because creating competitive provider networks in states where they don’t have any current customers is incredibly difficult.

In addition, insurers in states with tough regulations are fearful of having to compete against out-of-state plans that don’t have to adhere to the same rules.

“My insurers here absolutely cringe when you talk about across-state sales,” said Washington Insurance Commissioner Mike Kreidler, a Democrat.

Kreidler said he didn’t know how an executive order could ever be binding on a state. “I just can’t imagine it having that kind of impact. State law is going to supersede an executive order.”

But hey, that’s fine, right? Because as Trump has already demonstrated on any number of occasions, he’s not averse to using tax payer money to tilt at windmills after creating legal problems that didn’t exist.

Perhaps Andy Slavitt, who was the Obama administration’s top official at the Centers for Medicare and Medicaid Services, summed this effort up best when he told the Journal the following:

Its aim is clearly to do with the pen what Congress wouldn’t—eliminate pre-existing condition protections, essential benefit protections and lifetime caps and turn the ACA into a sparsely available high-risk pool.

 

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7 thoughts on “Trump Signs Health Care Executive Order, Here’s What It Really Means

  1. Yeah, but they might get a “beautiful” pen for acting as his morning idolaters, what a freak show. This idiot has no shame. And when does the “Mnuch” get roasted on SNL? What a freakin’ toad…

  2. As much as I dislike Trump and while being a two time Obama voter – I think the Affordable Care Act was a disappointing and monumental economic and health care disaster. First of all it has turned over health care to the insurance industry who isn’t known for its kindness, nor economic efficiency and profits from it the most. This couldn’t be more analogous to the old analogy of “letting the fox into the hen house.” In reality, the health care insurance industry is just an expensive no-value added for profit health payment management system. It adds costs to health care, it doesn’t save any costs. As such it isn’t surprising that under the ACA health care costs have continued to sky rocket.

    What the country needs is affordable health care where the medical and pharmaceutical industry parasites (enabled by the FDA and AMA) have to compete globally and not on an artificially level playing field. Turning over the health care industry to those that profit the most from it – as Obama did – was about the most economically uninformed thing he could have possibly done. Sure, we got uninsured people some coverage, but that coverage and the excessive overhead for it by the insurance industry – is being paid for by everyone, but it hits the middle class the hardest. Privatization doesn’t always produce the most cost efficient results – especially in artificially controlled market places.

    ACA was a stupid and political cowardly thing to do and was not worth economically the uninsured coverage that it has achieved. Essentially the ACA is privatized tax system that has only made the overall cost of US health care the most expensive in the world while being ranked as the absolute worst among the top 11 industrialized nations. (http://bit.ly/2yeQy5f).

    It is most embarrassingly stupid because in the end, we will do what all developed countries like Canada and most of Europe have done to achieve reasonable and affordable health care coverage and go to universal health care. Pretending to privatize universal coverage is and will continue to be an economic disaster for the middle class. Yep, it’s socialized medicine, but this is one case where the market place has become imbalanced by political manipulation and it is unreasonable to think that the market will correct this on its on. The playing field has to be leveled. What we lack in the health care is a general lack of aggressive competition. You can’t create artificial barriers like $50M to bring a drug to market as the pharmaceutical industry influenced – if not owned FDA has, and still have an affordable and competitive heath care system. The temptation to overcharge and or control expenses is far to great. This is why we don’t like monopolies of any kind – because they historically they stifle competition, create artificially high prices, and abuse consumers. However, you can also stifle competition through corrupt regulating gate keepers, corrupt legislators and their favored beneficiaries.

    Like most things – Trump knows the short list of many of the the biggest topical problems facing the country, but he is absolutely clueless in how to go about solving them or the resources and alliance that he needs to do so. This EO attempt to push ACA replacement and or reform is no less cowardly than what Obama did. The EO on the ACA is typical of Trump’s history of failing at something, loudly lying about his failing be a victory, creating some diversion or distraction – while he moves on to his next scam victim. Nothing good will come of Trump’s diddling with the ACA because he simply doesn’t have the intellectual chops, courage or political deal making ability to make it happen. Essentially, American health care consumers have been screwed by their “representative” government. The chances at this time seem slim to none that even the Ds will attempt to create a more competitive and economically efficient alteration of the ACA.

    Both Ds and Rs are responsible for the corrupt collusion with corporate health care and insurance and selling their voters out. Until we change the self-serving nature of US politics in both Parties, and demonetize for profit US “Democracy” – our election and political media industries – we will continue to be abused and raped by self-serving political/corporate alliances that not only don’t privatize a problem, but rather parasitize it – if not actually prey on the problem forever and the US public – such as the ACA.

    • I pretty much agree with the problems with the “medical and pharmaceutical industry parasites (enabled by the FDA and AMA)” but I don’t agree to tie those almost insurmountable problems to Obama. They worked on healthcare for about a year and a major goal to provide coverage for the uninsured and pre-existing issues was actually achieved. So, perhaps more a case of settling for what you can get and go back later for a bigger bite.

      I don’t blame Obama and I also was a twice voter and wish to hell he was still in the WH. They all knew this healthcare would come up again and perhaps be ready to fight again. Unfortunately asswipe and his tag-a-longs really have no idea what they are doing or how to fix it. And since the fucking moron would rather just erase anything Obama did with complete disregard to anyone else and the damage he does.

      I think the only way to make drastic changes in healthcare is to make drastic changes in both industries. They have the power because we let it happen. I, like most Americans, recognize the problem but I personally do not know how to fix it. My only suggestion has been to prohibit those industries from contributing to politicians (also the NRA). Take away their power.

      All this to say, please don’t blame Obama. He did work hard and he did a good job of what he was able to wring out of those corrupt cruel hands!

  3. No doubt Trump has an Obama superiority complex in that morass of racial prejudice and white supremacy brain. I still think ACA was an economic bridge too far. Perhaps in a longer analysis it will be the fulcrum that ultimately makes universal healthcare unavoidable. Sorry, still blame Obama because as I read – Obama had already made his deal with the healthcare industry before the election. No different than Bush did with the oil and MIC industries in his election.

    Not totally changing subjects – but indirectly related to Trump’s EO on healthcare: Normally, I don’t spend much time thinking about conspiracy theory, however Steve Bannon leaving Trump while seemingly necessary politically, it also seemed too easy and too convenient. Trump (not Trump)/Bannon strategist could be setting the Republican Party up for some nasty surprises.

    The Trump now habit of sending EOs directives to Congress while knowing they will do and or decide on nothing – does provide an opportunity for an extreme right wing party (more extreme than the current social conservative dominated Republican Party) to arise for 2020. The new Third (or does this make it Fourth) Reich can point to grid lock of the current Ds and Rs and say that a real “conservative” third party is needed to break it. They can point to current Republicans that refused to support the Trump/Bannon far right agendas. Bannon seems to be laying such foundation for a third party pathway with Breitbart and his other efforts.

    After seeing how many people came out for Trump in 2016 (and not believing that based on our current speed – we will have stopped Russian and other foreign meddling by then – if ever) I think a radical populist right wing may possibly produce a viable third political party in the US. If the current and D and R voters are further divided by a third Party voting opportunity who knows what might happen? It could explain the stream of Trump DOA – EOs to Congress. Just a thought – though not a pleasant one.

    • OK DUGGER, if you keep this up I am gonna have to refill my blood pressure meds before the auto refill kicks in! 🙂 STOP IT….one point before I close, asswipe does not have the cells required to conspire with anyone but Bannon has the moxy to use the dumbest tool in the box to get what he wants! The big scare you give me is that third party — even without Russia meddling, a 3rd party would be a mess. btw, if Facebook and twitter pay attention, Russia will need to find a new way into the game.

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