ACA Watch | January 24, 2017

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ACA Watch | January 24, 2017

ACA Watch January 24, 2017

Trump’s Executive Order – What happened?

President Donald Trump’s first day as President last Friday resulted in the issuance of an Executive Order, setting very broad policy directives for the Affordable Care Act (ACA.) An official press release regarding the Order is available via CNN.

Despite the Executive Order, the ACA can only be repealed by Congress. Executive Orders may be used by Presidents to create detailed changes regarding the United States’ foreign policy relationships. However, when an Executive Order regarding domestic policy is issued, the power is restricted considerably. Executive Orders cannot be used to change domestic laws or regulations, and lack detail overall. President Trump’s Executive Order sets broad policy objectives and allowed the Department of Health and Human Services (HHS) and other Agencies to interpret ACA law more liberally.

The Order also instructs the Health and Human Services (HHS) Secretary to carry out the details of the repeal process and grant exemptions to portions of the law.  Some actionable parts of the repeal process are contingent upon the HHS Secretary’s decisions.

Secretaries of Treasury, Labor, CMS Administration, and the IRS Commissioner will also affect these changes. Still awaiting confirmation, these individuals will be instrumental in implementing any systemic changes to ACA.


HHS Secretary Awaits Confirmation

Trump’s nominee for HHS Secretary, Tom Price, is still awaiting confirmation to his new position.

Representative Tom Price (R-GA) has been vocally resistant against the ACA, introducing repeal legislation to Congress on several occasions during his career.

Last week the Senate Health, Education, Labor, and Pension (HELP) Committee held a hearing for Price. During the hearing he was questioned about what the Republicans would do to replace the ACA. Price did not provide a specific plan, but remarked that it was “absolutely imperative that individuals have health coverage.”

Democrats questioned Price regarding conflicts of interest regarding his personal investments. He is scheduled to appear at another hearing in front of the Senate Finance Committee today, January 24, 2017.

Hearings by House Committees

In a previous session, the House and Senate adopted a budget resolution, granting four House and Senate Committees to submit legislative plans for repeal of the ACA.
The House Ways and Means Subcommittee on Investigations is expected to hold the first of these hearings to address the Individual Mandate component of ACA. This hearing is scheduled for today, January 24.

New Report from Congressional Budget Office

The Congressional Budget Office released an additional report, assessing the impact of ACA repeal. New findings suggest that around 32 million Americans would lose their health coverage within the first ten years after ACA repeal. Premiums are also expected to double within that time.


What Could Change?

Though changes to dismantle ACA will only be allowed “to the maximum extent permitted by law,” several things may change in the interim as a result of alternate interpretation of ACA law. Here’s what to expect:

  • HHS may more liberally grant innovation waivers to States, allowing sale of insurance in other states (still subject to state approval/consumer protections)
  • There may be new categories of hardship exemptions to the ACA individual responsibility mandate created
  • Increased number of  Section 1115 Medicaid waivers issued

The Congressional Budget Office cautions that repealing the individual responsibility requirement will greatly affect the insurance industry by reducing individual insurance enrollment numbers. An alternative method of encouraging healthy people to enroll in individual coverage would be necessary for the Trump Administration to preserve the individual insurance market.


As a long-time member of the Employers Council for Flexible Compensation (ECFC), Employee Benefits Corporation will continue to provide ACA Watch updates as legislation continues to evolve.

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