In case this is news to you, a president can't repeal an existing law with an executive order. Some (looking at you, Barack Obama) have to tried to enact de facto repeals by issuing orders refusing to enforce laws in whole or in part, but the law stays on the books when that happens.
So ObamaCare is still the law because John McCain, Susan Collins, Lisa Murkowski and Rand Paul are frauds. That being the case, Donald Trump made a move today to make the law loss costly, which is ironic considering its actual, formal name. Is it legal to do what Trump did? That's an interesting question, because ObamaCare mandates that insurance policies cover certain things, regardless of whether consumers want to pay for these things to be covered, and doesn't give consumers or insurers the option of negotiating plans that don't cover the mandated benefits.
Expand access to less expensive, less comprehensive insurance
Mr. Trump directed three cabinet agencies to develop rules that would expand access to less expensive, less comprehensive insurance, including policies that could be sold by trade associations to their members and short-term medical coverage that could be offered by commercial insurers to individuals and families.
Many of the new insurance products could be exempt from requirements of the Affordable Care Act that Republicans say have contributed to sharp increases in premiums but that supporters say have created a baseline of care that has protected consumers from “junk insurance.”
Administration officials said they had not yet decided which federal and state rules would apply to the new products.
Mr. Trump’s order could eventually make it easier for small businesses to band together and buy insurance through new entities known as association health plans, which could be created by business and professional groups. A White House official said these health plans “could potentially allow American employers to form groups across state lines” — a goal championed by Mr. Trump and many other Republicans.
Broader range of insurance options at lower rates in the large group market
The action on Thursday followed the pattern of previous policy shifts that originated with similar directives from the president. Within hours of his inauguration in January, Mr. Trump ordered federal agencies to find ways to waive or defer any provisions of the Affordable Care Act that might burden consumers, insurers or health care providers. In May, he directed officials to help people with religious objections to the federal mandate for insurance coverage of contraception.
Both of those orders were followed up with specific, substantive regulations.
In a summary of the new executive order, the White House said that a broader interpretation of federal law — the Employee Retirement Income Security Act of 1974 — “could potentially allow employers in the same line of business anywhere in the country to join together to offer health care coverage to their employees.” As a result, it said, “workers could have access to a broader range of insurance options at lower rates in the large group market.”
The broader range of options is the key. Democrats and the media would have you believe that the best possible circumstance for everyone is to have as many health services "covered" as possible by a third-party payer. The more "covered" you are, the better. But that's not always true. What you're covered for, you pay for in higher premiums. And when you're "covered," that means someone other than you is going to decide if you can get a certain service because they, not you, are going to pay the bill.
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You can make any market more stable, at least theoretically, if you force people to participate in it
Some of you might think that still sounds better than paying out of pocket, but a lot of people disagree. They are not high-volume consumers of health care services and don't like the idea that they have to pay to be "covered" for things they will almost certainly never utilize. The people in this group think they'd be making a far more rational decision to elect to pay out of pocket, at least up to a certain amount, rather than pay an insurer and then rely on that insurer. Trump's executive order at least starts us down the road to where more people can make that choice if they want to.
Democrats are howling that this will destablize insurance markets, and that's true to a degree. Insurance markets are always more stable when more people are paying more (and higher) premiums. But the ObamaCare scheme all along has been to create stable markets by forcing people to buy a product whether they want it or not. You can make any market more stable, at least theoretically, if you force people to participate in it.
This is why Democrat claims that "ObamaCare is working", which they base on enrollment numbers, is so hollow. When congressional Republicans were still trying (or pretending to try) to repeal ObamaCare, the left howled that repeal of the individual mandate would cause more than 20 million people to "lose" their insurance. What they actually meant was that 20 million people would now freely choose not to buy it, because they would once again have that option. This is how Democrats think: We're going to mandate that you buy something we think you need, and if you're ever allowed to stop buying it, we'll shriek that you've "lost" it.
If Democrats want the health insurance markets to be stable, they need to stop standing in the way of a total re-think on how health insurance works. Let it go back to being protection against risk instead of a third-party benefactor that pays everyone's bills for everything. That will bring premiums down, introduce price-consciousness into markets and give us not only stable but also rational markets - which would be one hell of a lot better than the one we have now. President Trump's executive order today is at least a step in that direction.
