Trump Signs Order Paving Way for Health-Care Changes

Critics say move will raise premiums for older, less healthy people

The Wall Street Journal
By Michelle Hackman
Updated Oct. 12, 2017 12:31 p.m. ET

President Donald Trump signed an executive order Thursday directing federal agencies to pursue sweeping regulatory changes to the health-care system, the administration’s first move in what it promises will be an extended campaign to weaken the Affordable Care Act without Congress.

The directive will not make immediate changes to the health-care system. Instead, it issues a broad directive to the departments of Labor, Treasury and Health and Human Services to explore regulatory options that would expand access to health-care plans that fall outside the purview of the ACA and its regulations.

Mr. Trump signed the order at a White House ceremony surrounded by small business owners. Vice President Mike Pence attended the event, along with several cabinet secretaries and Sen. Rand Paul (R., Ky.), who helped craft elements of the order.

“This will direct [departments] to take action to increase competition, increase choice, and increase access to lower-cost, high-quality health-care options,” Mr. Trump said. “This will cost the United States virtually nothing, and people will have great, great health care.”

The order directs agencies to ease rules that allow small businesses, and possibly individuals, to band together in arrangements called “association health plans,” letting them buy cheaper, less-comprehensive plans outside the ACA market.

It also eases the pathway for the sale of short-term insurance policies, which the Obama administration restricted. And it will permit employers to deposit money into special accounts that their workers can use to purchase their own insurance plans.

“The competition will be staggering, and insurance companies will be fighting to get everybody signed up,” Mr. Trump said.

Critics say these new options would drain the ACA market of younger, healthier customers, sending costs soaring for older and sicker people who remain in the regulated market. And if those healthier people do get sick, the critics say, they may find their coverage inadequate.

“Having failed to repeal the law in Congress, the president is sabotaging the system, using a wrecking ball to single-handedly rip apart our health-care system,” said Senate Minority Leader Chuck Schumer (D., N.Y.). “This order couldn’t be further from the ‘great health care’ the president promised.”

Mr. Trump, using his authority to accomplish some of what Republicans failed to achieve with their stalled congressional health-care overhaul, directed federal agencies to take actions aimed at providing lower-cost options and fostering competition in the individual insurance markets. The specific steps included in the order represent only the first moves in his White House’s effort to strike parts of the law.