3 reasons why Trump’s executive order on the ACA doesn’t do much
President Trump is wasting no time when it comes to health care reform—at least on a symbolic level.
Health care has been a top story since the election, from budget reconciliation to the various solutions the GOP is kicking around for a “repeal and replace.”
But Trump’s recent executive order, signed the day he took office, is the biggest yet, ordering the dismantling of the Affordable Care Act. It’s certainly newsworthy, but it may not have the effect many believe. Here’s why:
1. The executive order is an instruction manual, not a law.
More than anything else, Trump’s executive order acts as an instruction manual for other government agencies. Specifically, he’s passing along directions to the Department of Health and Human Services (to be headed by Tom Price) and the Department of Labor (to be headed by Andrew Puzder), which are in charge of handling the individual and employer health care mandates.
In the simplest sense, Trump is instructing them to disable the regulation “to the maximum extent permitted by law.” This could include waiving, minimizing, or delaying penalties for employers and individuals.
It’s meant to decrease the power of the law, but in truth nothing has changed. These departments always had the power to play with exemptions and penalties, based on the language of the ACA. All that’s changed is the attitude toward enforcement—expect it to be more lax under the new administration.
2. There’s still some red tape to work around.
However, there’s another complication. While Congress doesn’t need to approve the way government agencies enforce the law, there are other rules and regulations that keep these agencies from acting right away. The various departments in charge of enforcing the mandates will have to follow the Administrative Procedures Act (APA), which means that their new regulations (or lack thereof) may not go into effect for quite some time.
The APA says that before implementing new policies, government agencies must present a draft of their new policy to the world, accept feedback from the public, and implement them into the final draft of the rules. This takes time—when the individual mandate policy was first rolled out, it took over a year to go through this process. Rolling it back could take just as long.
3. True health care reform is a team effort.
Ultimately, Trump’s executive order may become obsolete before it even goes fully into effect. If Congress is able to put together a replacement bill before the APA procedures wrap up, the order will have been, in practice, useless. It’s definitely a sign of good will toward Trump’s supporters, who were told he’d repeal and replace the bill within his first 100 days as president, but it probably won’t do much in terms of real change. To do that, Congress needs to pull together a bill, pass it, and then send it to the White House to be signed.
The executive order also doesn’t change the importance of reporting and complying in 2017. It’s vital to continue your efforts as normal, despite this newest development and overall uncertainty regarding the future of health care reform. The executive order doesn’t change the law—it simply opens the door to make pieces more lenient over time.