Cheaper options for healthy people, as long as they stay healthy.

By David Meyer
October 12, 2017

President Donald Trump is reportedly preparing to sign an executive order Thursday that will partially dismantle his predecessor’s Affordable Care Act (ACA), also known as Obamacare.

The move is a response to Congress’s repeated failure to organize an ACA repeal, which was one of Trump’s main campaign pledges. It is likely to only be the start of several moves to roll back Obamacare. But what will this executive order say?

According to a report in The Wall Street Journal, which cited unnamed White House officials, there are a few key elements to the order.

The first would direct the Department of Labor to make it easier for small businesses and maybe individuals to form “association” health plans that are exempt from requiring certain benefits. Another would expand access to short-term health plans that are again more flexible, making it possible to refuse coverage to those with pre-existing conditions.

Both of these moves could benefit healthy people whose premiums have gone up under the ACA, and who want a cheaper option. However, those same people may find themselves in worse circumstances if they end up getting sick with uncovered conditions.

And if healthier people migrate to alternative plans, sicker people remaining in the ACA marketplaces may end up having to pay more — the very nature of insurance, after all, is to pool risk. This was why the ACA limits short-term health plans to three months and does not allow their renewal.

The WSJ report also indicated that the order will allow employees with employer-funded “health reimbursement arrangements” to use them when purchasing their own plans. Trump will also tell agencies to report back on federal and state policies that might be bumping up health costs, including consolidation in the market.

The White House officials who informed the piece apparently did not think the order could be litigated, with agencies being given the responsibility to come up with the details.

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