The WasteWatcher: The Staff Blog of Citizens Against Government Waste

President Trump's Executive Order on Healthcare

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.

Today, President Donald Trump signed an Executive Order (EO), "Promote Healthcare Choice and Competition Across the United States,” with the goals of bringing financial relief and more healthcare choices to millions of Americans. Since the Patient Protection and Affordable Care Act (ACA), or Obamacare, was signed into law, Americans have seen their health insurance options limited while their premiums and deductibles have soared.

Employees that work in small firms have seen their employer health benefits decline under Obamacare.  According to data from a Kaiser Family Foundation /Health Research and Education Trust survey, firms with 3 to 24 employees have seen a drop of 12 percent in benefits and firms with 25 to 49 workers, have seen a drop of 14 percent.

To reverse this reduction in benefits, the EO directs the Secretary of Labor to consider a broader interpretation of the Employee Retirement Income Security Act, or ERISA, that would permit the expansion of Association Health Plans (AHPs).  This would allow small employers across the country to band together and purchase group insurance.

The EO also directs the Treasury, Labor, and Health and Human Services Departments to consider making changes to Health Reimbursement Arrangements (HRAs).  Similar in some respects to Health Savings Accounts (HSAs), an HRA is an employer-funded account that reimburses employees for healthcare expenditures and are not taxed as income.  The EO action would reverse Obamacare rules regarding HRAs and employers would have more options in providing healthcare to their employees.

And the EO also directs the Treasury, Labor, and Health and Human Services Departments to consider expanding short-term limited duration insurance (STLDI).  The primary reason for a STLDI is to provide healthcare coverage for people between jobs who do not want to pay for continuation of their employer-sponsored health insurance under the Consolidated Omnibus Budget Reconciliation Act or COBRA, which tends to be expensive.  STLDI plans would also help individuals that are living in counties where there is only one insurer on the Obamacare exchange or those individuals that missed open enrollment.

Because STLDI plans are not bound to Obamacare’s heavy-handed regulations, they tended to be less expensive and people were using them for longer-term healthcare coverage.  As a result, the Obama Administration attempted to diminish the use of STLDI plans by limiting their length of use to less than three months.  The EO will reverse the Obama Administration rule and allow STLDI plans to be subjected once again to state regulations, permit them to be used longer, thus increasing choice and more innovation.

Is President Trump’s EO the answer to healthcare reform?  No, but it will provide some relief for millions of Americans.  The real solution lies with Congress living up to its promise to repeal and replace Obamacare.

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