October 12, 2017 -The President Signs Executive Order
President Donald Trump has signed an executive order intended to expand health care choices and increase competition to lower premium costs for consumers.
The executive order states- "It shall be the policy of the executive branch, to the extent of the law, to facilitate the purchase of insurance across State lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people. The Patient Protection and Affordable Care Act has severely limited the choice of healthcare options available to many Americans and has produced large premium increases in many State individual markets for health insurance. The average exchange premium in the 39 States that are using www.healthcare.gov is more than double the average overall individual market premium recorded in 2013. The PPACA has also largely failed to provide meaningful choice or competition between insurers, resulting in one-third of America's counties having only one insurer offering coverage on their applicable government-run exchange in 2017."
The administration has prioritized three areas for improvement:
Association Health Plans (AHP) Within 60 days - AHPs are an existing alternative to group health insurance, where businesses pool together in order to buy group health insurance. AHPs are a type of multi employer welfare arrangement and are intended to give more purchasing power and lower premiums outside of the small group market. AHPs have been subject to state laws for many years, additional restrictions were added with the ACA through the essential health benefits and restraints on premium rating requirements. The order directs the Secretary of Labor to propose regulations to expand conditions satisfying the requirements to access AHPs. The Secretary of Labor should consider ways to promote AHP formation on the basis of common geography or industry.
Short-term , Limited-duration Insurance (STLDI ) Within 60 days - STLDI plans are exempt from ACA reform requirements therefore are generally more affordable. The order directs Secretary of the Treasury, Labor and Health and Human Services to consider regulation to expand the availability of low cost STLDI, extend the availability from 3 months to 12 months as well as the ability to renew.
Health Reimbursement Arrangements (HRA) Within 120 days - HRAs are tax advantaged based accounts that reimburse employees for healthcare expenses such as, deductibles and co-payments. The order directs Secretary of Treasury, Labor and Health and Human Services to consider regulation to increase the usability of HRAs, expand employer ability to offer HRAs to their employees, and the availability for HRAs to be used in conjunction with non group coverage.
The Impact - The executive order does not make specific changes at this time. It directs federal agencies to create new regulations in order to implement the order's policies. Since policy regulation and guidance will take time and will not be implemented prior to the November 1 open enrollment period, it is unlikely these changes will significantly impact health insurance plans for 2018. Until new policies are in place, we recommend individuals and employers continue with deadlines and requirements for compliance with the ACA.