Trump’s Health Care Executive Order Explained

The affect of Trump’s executive order won’t be felt for at least six months. The reason is that the Departments of Health and Human Services, Labor, and Treasury all need to change current regulations. In order to changed those regulations, the departments must follow the federal rule making process. This means there will be, at a minimum, a public comment period attached to the proposed changes. Since the typical insurance contract runs from January 1 to December 31, I don’t see the worst of the changes beginning until 2019.

There are two primary pieces to the order: expanding access to association health plans (AHPs); and increasing short-term insurance plans.

Typically, AHPs have been available to trade associations and small businesses that operate in the same field. Under current law, AHPs are subject to the rules of the Affordable Care Act. People with preexisting conditions can’t be turned away and plans offered by associations must cover the essential health care benefits. Since the annual and lifetime caps on how much insurers will pay are tied to the essential benefits, there are currently no caps associated with AHPs.

Trump’s executive order seeks to remove all protections provided to customers of AHPS. People with coverage through an AHP will no longer be guaranteed things like maternity care, mental health coverage, and prescription drug coverage.

AHPs will be free to charge people with preexisting conditions whatever they like or deny them coverage entirely.

AHPs will be sold across state lines. This means your employer, if it qualifies for AHP coverage, will have the ability to join an AHP that follows the regulations of any state in the country. You could wind up with insurance that covers much less than is currently deemed acceptable by your state.

Currently, short-term plans can only last for 89 days. They can’t be renewed without the insurer’s permission. They do not have to offer the essential benefits and there is a cap (typically a million dollars) on what insurers will pay.

Trump’s order extends the length of short-term plans for a year and makes them renewable. It does nothing to affect the coverage they provide. Trump is converting the current short-term plans into long-term junk insurance.

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