President Donald Trump still hasn’t managed to repeal Obamacare, so he’s working hard to ruin it instead.
Fresh off the collapse of the GOP Congress’ campaign to repeal the Affordable Care Act, Trump is eyeing unilateral actions to weaken the law’s health insurance program and taking steps to undermine the upcoming enrollment season.
Speaking to reporters Wednesday, Trump said he’s planning to issue “an executive order on associations” ― a reference, most likely, to so-called association health plans, through which small businesses and in some cases individuals buy health insurance as a group. It’s possible that the federal government could allow some people to get cheaper, less generous coverage through these associations ― but only by taking healthy, working-age people out of the rest of the insurance market, destabilizing it and leading to higher costs for others.
And the Trump administration is pulling back on the Department of Health and Human Services’ efforts to promote health insurance enrollment on the Affordable Care Act’s exchanges via HealthCare.gov. This is the latest move the administration has taken to reduce federal support for public education and sign-up assistance for the open enrollment season that begins Nov. 1 and ends Dec. 15.
These things fit into a broader pattern, dating to before Trump’s inauguration, of sabotaging the Affordable Care Act’s health insurance marketplaces through action and inaction. Trump has repeatedly declared he wants to see the Obamacare exchanges fail as a means of extracting concessions from congressional Democrats.
Executive action on association health plans could help Trump realize his goal, although at this point it’s difficult to know exactly what his administration is planning to do ― or even what the law would allow them to do.
Association health plans have been around for a long time, offering coverage to small businesses and individuals through trade organizations. Prior to the ACA’s enactment, they were subject only to state regulation, which meant their benefits and availability varied enormously.
The 2010 health care law lays down new rules for insurance companies selling to individuals and to small businesses ― like charging all consumers the same premiums, regardless of pre-existing conditions, and requiring that all plans include a set of essential benefits. President Barack Obama’s administration, through official “guidance,” made clear that all the…