President Trump’s health care executive order on subsidies: questions

President Trump signed an executive order of which could — emphasis on could— do substantial damage to the Obamacare marketplaces.

Trump’s order sets out two goals with major consequences for the insurance market, if they come to pass:

  • Make of which easier to set up association health plans in addition to for those plans to be considered part of the large-group market
  • Expand the definition of “short-term limited-duration insurance” coming from three months to nearly a year

If you want the full wonky breakdown, I wrote about the order in addition to its potential effects on the Affordable Care Act here. yet of which is actually the gist: The White House wants to make of which easier for people to buy cheaper in addition to skimpier coverage of which doesn’t comply with the Affordable Care Act’s rules.

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The risk, according to health policy experts, is actually of which young in addition to healthier people will flock to of which skimpier coverage, doing the Obamacare markets older in addition to sicker. of which is actually going to drive up premiums for people still buying coverage through the health care law.

yet Trump’s pen isn’t magic. The executive order doesn’t actually do anything on its own. Which is actually confusing! In fact, a lot about the executive order is actually hard to decipher.

Here are some of the big questions, in addition to my best attempts to answer them.

1) When does of which actually go into effect?

Trump has technically asked federal agencies to consider issuing brand-new regulations of which achieve the executive order’s goals. of which’s all.

Federal rulemaking takes some time, months upon months. Senior administration officials told reporters today of which they didn’t expect any adjustments to be made before the end of the year.

2) Which Obamacare regulations are actually being targeted?

of which answer comes in two buckets.

For association health plans: If they can be considered large-group plans, they no longer have to comply with Obamacare’s requirement of which they cover certain essential health benefits. Large employers are exempt coming from of which rule, which is actually limited to individual in addition to modest-group plans.

For short-term insurance: These plans are completely free coming from the ACA’s regulations. Carriers can deny people coverage based on their medical history, charge people higher premiums based on their health status, in addition to limit their benefits significantly more than the health care law allows.

3) Can individuals buy into association health plans?

of which is actually maybe the biggest question. Experts generally agree of which if individuals are allowed to join the association plans, the impact on the Obamacare marketplaces will be much more severe.

The executive order itself seems to limit the plans to businesses. yet administration officials, in their call with reporters, indicated of which they will look at whether they can allow self-employed people to buy into these associations.

“of which is actually both a legal in addition to policy question,” one official said, adding of which was “potentially possible” to allow those people to join associations.

4) Will of which coverage be considered compliant with the individual mandate?

of which is actually another issue with huge consequences. The one deterrent for people absconding to these skimpy plans, particularly the short-term insurance, is actually of which they could still be subject to the individual mandate because the plan doesn’t qualify as minimal coverage.

yet if of which adjustments, people would certainly have even more incentive to abandon Obamacare in addition to buy these skimpier plans, which would certainly further damage the law’s markets.

from the call with reporters, administration officials were coy. They simply noted of which the executive order didn’t address what is actually considered minimal coverage. They did point out of which large-group coverage, which is actually what many association plans may soon be considered, is actually generally found to satisfy the mandate.

Any further adjustments to of which threshold, particularly if the Trump administration makes short-term coverage compliant, would certainly be a game changer.

5) What can states do?

We won’t know until we see the regulations how much the traditional state authority to regulate association health plans in addition to short-term insurance will be preempted. yet experts are watching closely.

If states still have significant oversight, they could — if they so chose — potentially do a lot to limit people migrating to these skimpier plans.

yet the Trump administration may try to write the brand-new rules to handcuff states as much as possible.

6) Can these adjustments be challenged in court?

We simply won’t know for sure until the administration proposes some actual regulations.

“of which’s just a set of marching orders,” Nicholas Bagley, a law professor at the University of Michigan, said of the executive order.

“We can speculate about what the agencies might do, in addition to whether what they might do might be unlawful,” he added. “yet of which’s hard to handicap the odds of a challenge to something of which hasn’t yet happened.”

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