In the first few days of his Administration, President Trump issued several Executive Orders. Of particular note for the health care system and health centers was his first Executive Order, Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal. We have heard from many health center advocates who want to know how this action will affect their centers and their patients.
Let’s look at what Executive Orders are and how this will impact the health care environment.
What is an Executive Order?
By definition, an Executive Order is “a rule or order issued by the president to an executive branch of the government and having the force of law.” These have been used by almost every President and are often a way for the President to use his or her authority to outline and implement policies, without Congressional approval. They are also used symbolically to send a message about a President’s policy agenda or proclamations such as “National Health Center Week.”
What did this Executive Order do?
First and foremost, while the Executive Order does technically carry the weight of the law, it cannot and did not repeal the Affordable Care Act. That cannot be done without Congressional action.
The Executive Order stated that President Trump would like to see the “prompt repeal of the Affordable Care Act” and instructed Federal agencies, such as the Department of Health and Human Services, to reduce the “economic burden” of the ACA while it waits for Congressional action. Specifically, the Executive Order instructed agencies to:
- “take all actions consistent with law to minimize the unwarranted economic and economic burdens of the Act”
- “waive defer, or grant exemptions from ACA requirements” and
- grant states “greater flexibility in implementing health care programs”
The Order also states that agencies must follow proper rule-making procedure to change any regulations that are already in effect.
What remains to be seen by all in Washington and across the country, is how the Administration follows through on these steps and what impact it will have on the health care environment
One complication is timing – Representative Tom Price, the Administration’s nominee for Secretary of Health and Human Services, and Seema Verma, the nominee for Administrator of the Centers for Medicare and Medicaid Services, are both awaiting confirmation before they can assume their new roles. Further, it is still unclear how the Executive Order will impact Congress’ work on repealing and replacing the Affordable Care Act, including whether it might make them feel that they can take more time to decide upon next steps. One concern mentioned is that the new Administration might immediately stop enforcing the tax penalty behind the individual mandate, but during his confirmation hearing yesterday, Representative Price stated that he would not take administrative action to undermine the mandate in advance of Congress repealing and replacing the law.
Feel free to stay in touch with NACHC about any questions or concerns you might have about Executive Orders as we all watch closely to see what impact this will have at the national, state and local level.