On January 20, just hours after his swearing in ceremony, President Donald Trump issued his first executive order. The order directs his agencies to "waive, defer, or grant exemptions to any provision of the ACA [Affordable Care Act] to the maximum extent permitted by law." Though the order does not contain specific or detailed instructions about which provisions of the law should be addressed, it is a strong statement against the law that remained highlighted throughout the presidential campaign. The executive order directs and authorizes agencies to roll back regulations, cease to enforce provisions, and otherwise nullify provisions set through the regulatory, rather than the legislative, process.
Congress acted last week to address portions of the ACA that impact the budget through a budget reconciliation bill. (See WICs article, "Senate Budget Vote Clears Path to ACA Repeal," January 12, 2017.) Trump has said that he supports a fast repeal of the ACA, which must be done by Congress. In the order, Trump wrote, "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." Though the repeal of the ACA has been a major talking point by Republicans in Congress for years, they have been cautioned, including by those within their own ranks, against any repeal that does not include a replacement plan.
The Congressional Budget Office (CBO) issued a report last week saying that if the law was repealed without a replacement, it could result in 32 million people losing health insurance, and a doubling of premiums over the next ten years.