KHN Morning Briefing

Summaries of health policy coverage from major news organizations

full issue

Trump’s Executive Order Scaling Back Health Law Injects Uncertainty In Already Unstable Industry

The president instructs all federal agencies to “waive, defer, grant ­exemptions from or delay” any part of the law that imposes a financial or regulatory burden, but the practical implications and potential fallout from the order are still unclear.

The Washington Post: With Executive Order, Trump Tosses A ‘Bomb’ Into Fragile Health Insurance Markets
The practical implications of Trump’s action on Friday are harder to decipher. Its language instructs all federal agencies to “waive, defer, grant ­exemptions from or delay” any part of the law that imposes a financial or regulatory burden on those affected by it. That would cover consumers, doctors, hospitals and other providers, as well as insurers and drug companies. The prospect of what could flow from pulling back or eliminating administrative rules — including no longer enforcing the individual mandate, which requires Americans to get coverage or pay an annual penalty, and ending health plans’ “essential benefits” — could affect how many people sign up on the Affordable Care Act marketplaces before open enrollment ends Jan. 31 for 2017 coverage, as well as how many companies decide to participate next year. (Eilperin and Sullivan, 1/22)

The Associated Press: How Trump’s Executive Order Impacts Future Of ‘Obamacare’
The one-page directive gives agencies authority to grant waivers, exemptions and delays of provisions in the Affordable Care Act. But until it becomes clear what steps federal agencies take as a result, its full impact on Americans and their health insurance is uncertain. Here’s a look at Trump’s executive order. (Pace and Alonso-Zaldivar, 1/21)

Modern Healthcare: Trump's ACA Executive Order Heightens Insurance Market Jitters
It's possible that facilitating the ACA's collapse is Trump's goal. He tweeted earlier this month that Republicans should let Obamacare “fall of its own weight” and make “the Dems own the failed Obamacare disaster.” If he and the GOP can convince the public that the law unraveled on its own, that would make their job of repealing and replacing it politically easier. (Meyer, 1/22)

The Wall Street Journal: Donald Trump’s Health-Law Directive Spurs A Dash To Decode It
The executive order suggests the new administration intends to take swift action on its own if necessary, with a particular eye to the health law’s centerpiece requirement that most individuals buy insurance or pay a penalty. Removing that penalty would be popular in some quarters. It could also set in motion a chain of events that would hasten the collapse of the individual insurance market, and with it the health law, if no other steps were taken. Insurers losing a guaranteed customer base, while still being forced to insure sick people, could move to pull out of some markets or signal plans to dramatically increase premiums, with uncertain political consequences. (Radnofsky and Armour, 1/22)

NPR: Trump's Executive Order Could Dismantle Parts Of ACA Before Replacement Is Ready
Trump's order also pushes one of his favorite health care ideas — to allow insurance companies to sell policies across state lines — by encouraging "the development of a free and open market in interstate commerce for the offering of healthcare services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers." (Kodjak, 1/21)

Stat: Trump Executive Order Puts Contraception Mandate At Risk
Much will depend on how the Department of Health and Human Services interprets Trump’s orders. The first order itself does not mandate any specific actions. But the contraception mandate would be an obvious target. It is widely loathed by conservatives, who allege it encroaches on religious freedoms, and the Obama administration enacted it through the broad regulatory authority that the law granted to HHS. It is not etched into law by the ACA itself. (Scott, 1/21)

Reuters: Trump Order Paves Way For Agencies To Weaken Health Law
Republican lawmakers, who are working on new legislation to repeal and replace Obamacare, praised the order as showing Trump’s commitment to gutting the program and lowering steep healthcare costs they blame on the law. Trump did not specify which parts of the program would be affected by his order, and any changes are unlikely to affect the government-funded or subsidized insurance plans covering more than 20 million people in 2017. (Morgan and Cornwell, 1/21)

Politico: How Trump Can Use Obamacare To Kill Obamacare
Conservatives who railed against Barack Obama's vast powers to build up the Affordable Care Act declared vindication Saturday with President Donald Trump’s executive order to tear it apart. "For me, it’s a mix of irony and schadenfreude," says Josh Blackman, a law professor who's written two books that criticized the Obama administration's implementation of the law. "I’ve warned for years that, with a new president in the White House, the exact same powers could be used for different purposes. That’s what we’re seeing now, to a T." (Diamond, 1/22)

CQ Roll Call: Trump Issues Executive Order On Obamacare
“It is heartening to see President Trump take immediate action to begin undoing the damage caused by Obamacare,” Energy and Commerce Chairman Greg Walden of Oregon said in a statement. “In the coming weeks, we will repeal Obamacare and begin rebuilding our broken health care system and cleaning up the mess left behind by the previous administration.” (Williams, 1/20)

CNN Money: Trump's Executive Order And Obamacare: Where We Go From Here
"It's a mix of symbolic arm waving (lacking more specific and targeted details) and directional guidance to empower Trump administration officials to lean against more regulation on the margin," said Tom Miller, resident fellow at the American Enterprise Institute, which has long opposed Obamacare. "What remains unclear is how far they can go before they bump up against clearer statutory requirements and existing final regulations." (Luhby, 1/22)

Los Angeles Times: Here's What Trump's Executive Order Really Means For Obamacare
Has Obamacare been repealed? In a word, no. The healthcare law was a huge piece of legislation that included scores of legal requirements and provided hundreds of billions of dollars in assistance to help extend health coverage to millions of Americans. All that can only be repealed by another law, which would require an act of Congress, not just an executive order from the president. (Levey, 1/21)

Modern Healthcare: President Trump's Healthcare Plate Is Full, And It Won't Go Down Easy
[As Trump] takes office, he faces the very real prospect that his first year in the White House could be dominated by complex and bitterly divisive healthcare issues, carrying big political risks for his presidency and his party. ... If he fails to fulfill his vow to repeal and replace the law with something much better, Republicans could be in a vulnerable position defending their control of Congress in the 2018 elections, putting the second half of Trump's presidency in jeopardy. A more immediate risk is that Trump's and congressional Republicans' broader agenda on taxes, the economy, trade, deregulation, immigration, military expansion and other issues could get derailed by health policy battles. (Meyer, 1/20)

Kaiser Health News: Trump Stays Silent On Health Law In Speech, Then Sets Tone For Repeal
President Donald Trump’s brief inaugural address mentioned many of the issues he raised repeatedly on the campaign trail — jobs, immigration and trade policy. But there was not even a brief mention of his plans to improve health care. The new White House website was similarly silent on anything health related. Under the “issues” section it includes energy, foreign policy, jobs, the military, law enforcement and trade. But no health section. (Rovner, 1/20)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.