Commentary, Trump Administration

Speak bigly, carry a small pen: Trump’s executive order on the Affordable Care Act

Donald Trump speakingOn his first day in office, President Trump signed an executive order targeting the Affordable Care Act (ACA). Since then, much as been made about what the executive order might mean. Because Congress has failed to come up with a repeal-and-replace plan as expeditiously as promised during campaign season, it seems that the executive order seeks to say a lot without doing very much in the short term.

Unfortunately, media coverage of the executive order has served the President’s goals—to confuse the public and subvert confidence in the law. Much like the congressional votes earlier this month to pass a budget resolution starting the process of repeal, the executive order has no impact on policy and makes no immediate changes to the law. What’s more, while the order makes references to curbing “economic and regulatory burdens” of the law, it grants no new authority to executive agencies. Any proposed changes—such as eliminating the individual responsibility provision of the law and others—would have to come through normal regulatory or legislative channels.

But here’s what the order does do: it signals the administration’s commitment to dismantling the gains that we’ve seen under the ACA. What’s more, it irresponsibly signals an urgency to undo the ACA without first enacting a plan to replace the law.

That’s dangerous for not only millions of Americans who benefit from the law, but it causes chaos for the insurance market. Insurance companies will have to apply to sell 2018 Marketplace plans by May; why commit to selling plans for 2018 if the Trump administration is not committed to maintaining a stable market? That’s especially true if the GOP pursues a reckless repeal-and-run strategy, seeking to repeal the law, delay the effective date, and come up with a replacement plan later.

Therefore, while largely symbolic, the executive order jeopardizes market confidence, which will likely contribute to an exodus of insurers from both the Marketplace and the non-Marketplace individual market. Think having only Blue Cross plans in every county is bad? Wait until no one is willing to sell.

At the end of the day, the ACA is still the law of the land, and consumers can continue to sign up for 2017 coverage until Open Enrollment ends next week on Tuesday, January 31. Don’t let the administration’s distractions fool consumers into thinking that enrolling is futile—financial help is still available, and most people are still required to have coverage. North Carolinians should enroll while they still can.

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In dozens of vitally important areas, policy decisions of the Trump administration are dramatically affecting and altering the lives of North Carolinians. This growing collection of stories summarizes and critiques many of the most important decisions and their impacts.