US President Donald Trump has launched a new assault on Obamacare, signing an executive order that will allow the sale of health insurance plans that are exempt from some of its requirements.
The move follows several failed attempts to force a repeal through Congress, despite making it a key campaign pledge while running for office, and is seen by some commentators as Trump trying to take the process out of lawmakers’ hands and in the process defying his own party.
Trump insists the order is “taking the first steps” towards repealing and replacing his predecessor’s Affordable Care Act, which he claimed has been blighted by “skyrocketing” premiums since it was enacted. The healthcare package said it will increase access and choice and will make healthcare coverage available to millions more people, he said at a press conference ahead of the signing.
So what does it actually say? Among the measures is that it tasks the administration with making it possible for small businesses – and maybe individuals – to form associations to buy insurance, including across state lines, to boost competition, although critics allege that will encourage the creation of cheaper policies with fewer benefits.
It also calls for the introduction of ‘short-term, limited duration insurance’ that will sidestep some of the Obamacare regulations such as protections for people with pre-existing conditions, as well as expanding the use of tax-free health reimbursement accounts (HRAs) to help businesses compensate employees who choose to make their own healthcare arrangements.
The changes could take six months or more to take effect, according to the administration.
“It will be better, and will cost us nothing,” he claimed, adding that the order “is just the beginning” of the process to achieve the repeal of Obamacare in Congress and bring to an end legislation that “has severely limited the choice of healthcare options available to many Americans and … resulted in one-third of America’s counties having only one insurer offering coverage on their applicable government-run exchange in 2017”.
There are concerns that the plans will lead to an exodus of younger people with fewer health concerns from Obamacare in pursuit of policies that are cheaper but provide less cover. In return, that would cause premiums to rise for the older, less healthy people remaining in ACA policies.
Senior Democrats have accused the President of trying to undermine and destroy Obamacare, having failed to make a successful political case for repealing it.
“Having failed to repeal the #ACA in Congress, @POTUS is using a wrecking ball to singlehandedly rip apart & sabotage our healthcare system,” tweeted New York Democrat and Senate Minority Leader Chuck Schumer.
The American Hospital Association also voiced its concerns, saying that the order “will allow health insurance plans that cover fewer benefits and offer fewer consumer protections”.
“No one can predict future health care needs with complete certainty and such plans could put patients at risk when care is needed most.”