On his first day in office President Trump signed an executive order for the “prompt repeal of the Patient Protection and Affordable Care Act.”  As news spread, many Americans experienced panic and confusion. With less than a week left in 2017 open enrollment (it concludes January 31), did this action mean the plan you already enrolled in was obsolete or that you could no longer enroll if you hadn’t already?
No and no. So what exactly does the executive order say and mean? There are a few things you should know right now, which will help guide you in the weeks ahead.
The president’s executive order carries very little weight at this time. The ACA remains fully in effect, and nothing has changed. Essentially, the executive order communicates Trump’s desire to repeal and replace the law as soon as possible and calls on his administration to act.
In Section 1, it states:
It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act (Public Law 111-148), as amended (the "Act"). In the meantime, pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market.
The order ends with Section 6 (c) as follows:
This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
Trump’s executive order minimizing the economic burden of the Patient Protection and Affordable Care Act pending repeal
You may have heard about a plan proposed by Republican senators Bill Cassidy, La., and Susan Collins, Maine. Revealed on Monday, January 23, the Patient Freedom Act of 2017 (PFA) essentially gives states more power to create healthcare policy and provides them with the option to keep the ACA if they like it. A one-pager for the PFA highlights the following details on what would be repealed and what would remain intact:
Repeals: This proposal repeals burdensome federal mandates imposed by the Affordable Care Act, such as the individual mandate, the employer mandate, the actuarial value requirements that force plans to fit into one of four categories, the age band requirements that drive up costs for young people, and the benefit mandates that often force Americans to pay for coverage they don’t need and can’t afford.
Keeps: This proposal keeps essential consumer protections, including prohibitions on annual and lifetime limits, prohibition of pre-existing condition exclusions, and prohibitions on discrimination. It also preserves guaranteed issue and guaranteed renewability and allows young adults to stay on their parents’ plan until age 26, as well as preserving coverage for mental health and substance use disorders.
Keep in mind this is only a proposal, and Collins expressed that it is a work in progress that is open to refinement. Again, Obamacare (i.e., the ACA) remains fully in effect. Nothing has changed.
The ACA’s individual shared responsibility provision (i.e., individual mandate) requires most Americans to have minimum essential coverage unless they are exempt. This still applies and will remain in effect until legislation stating otherwise repeals or replaces it.
Individual health insurance plans that qualify as minimum essential coverage remain available on and away from the ACA’s state-based, partnership and federal exchanges. Open enrollment for 2017 health plans ends on January 31. After this date, you must qualify for a special enrollment period to purchase an Obamacare plan.
Income-based premium tax credits and cost-sharing reductions are still available to those who qualify and who purchase coverage from the state-based, partnership and federal exchanges. Depending on the exact repeal-and-replace legislation that takes effect, subsidies could be instantly revoked when such legislation takes effect. That means you could end up paying your full monthly premium and out-of-pocket costs.
No matter what happens, insurance companies will need time to respond and state regulators must approve any proposed updates to plan pricing and benefits. Changes are unlikely to occur to plans until 2018.
While we know the Trump administration wants Obamacare to be swiftly repealed and replaced, it is likely to take a few months for anything to be finalized.
We know very little about what will happen next, but as the future of healthcare reform continues to unfold, it will be important for all of us to remain informed. Here are a few actions you can take right now:
1. Follow the news, and check here for explanation and analysis.
2. Use your current health insurance plan. Take advantage of preventive care benefits to help ensure you are healthy as well as to anticipate any healthcare needs you may have this year.
3. Speak with your insurance professional if you have questions or concerns about enrollment.
4. Contact your elected officials to weigh in on repeal-and-replace legislation.
5. Consider supplemental health products [Link to article] that help with out-of-pocket healthcare expenses not covered by your Obamacare plan.
Learn how to save on out-of-pocket healthcare expenses!
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 The White House. Office of the Press Secretary. “Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” January 20, 2017. https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and
 Shesgreen, Deirdre. “GOP senators outline first Obamacare Replacement Plan.” USA Today. Jan. 23, 2017. http://www.usatoday.com/story/news/politics/2017/01/23/gop-senators-outline-first-obamacare-replacement-plan/96951118/
 Patient Freedom Act of 2017 one-pager. http://www.cassidy.senate.gov/imo/media/doc/One%20Pager%20(1.20.17)%20(002).pdf
 Lee, MJ. “GOP Senators Present Obamacare Alternative.” CNN. Jan. 23, 2017. http://www.cnn.com/2017/01/23/politics/collins-cassidy-obamacare-repeal/index.html
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