President Trump Executive Order, October 2017
Please note: Rules have not been proposed or finalized for the Executive Order.
This process could take many months. ACA is still the law of the land.
The order directs the Secretary of Labor to consider expanding access to Association Health Plans (AHPs), which could potentially allow American employers to form groups across State lines.
- A broader interpretation of the Employee Retirement Income Security Act (ERISA) could potentially allow employers in the same line of business anywhere in the country to offer healthcare coverage to their employees.
- It could potentially allow employers to form AHPs through existing organizations, or create new ones for the express purpose of offering group insurance.
- Could make it easier for employers to band together, workers could have access to a broader range of insurance options at lower rates in the large group market.
- Employers participating in an AHP cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions.
The order directs the Departments of the Treasury, Labor, and Health and Human Services to consider expanding coverage through low cost short-term limited duration insurance (STLDI).
- STLDI is not subject to ACA mandates and rules.
- STLDI typically features broad provider networks and high coverage limits.
- The main groups who benefit from STLDI are people between jobs, people in counties with only a single insurer offering exchange plans, people with limited coverage networks, and people who missed the open enrollment period but still want insurance.
The order directs the Departments of the Treasury, Labor, and Health and Human Services to consider changes to Health Reimbursement Arrangements (HRAs) so employers can make better use of them for their employees.
- HRAs are employer-funded accounts that reimburse employees for healthcare expenses, including deductibles and copayments.
- The IRS does not count funds contributed to an HRA as taxable income.
- Expanded HRAs could potentially give American workers greater flexibility and control over how to finance their healthcare needs.
The percentage of workers at small firms receiving coverage through their employer has declined from nearly half in 2010 to about one-third in 2017.