What’s next: There are still plenty of big outstanding questions about how each of these policies would work, which federal agencies will have to fill in through regulations. (The executive order itself is just a set of marching orders to those agencies.) That’s a long process, and insurance companies have already finalized their most of their offerings for 2018, so these changes won’t be reflected in actual insurance plans until 2019.
The details: Administration officials confirmed that the order will do three big things:
- Expand access to association health plans, in which a group of small employers can band together to buy insurance as a collective.
- Expand access to short-term health plans. These policies don’t cover much and don’t cost much; today, you can only keep one for three months. Trump will extend that time limit to a year.
- Expand the use of health reimbursement accounts, which allow employers to set aside tax-free money to help cover their employees’ health care costs. Workers will likely be able to tap that money to pay the premiums for a plan in the individual market.
The reviews: Conservatives are thrilled. Sen. Rand Paul, a champion of association health plans, will be at the White House for the signing.
But many independent policy analysts are less enthusiastic. They worry that these changes will divert healthy people into cheaper policies outside the ACA’s exchanges, leaving those markets with a sicker and more expensive customer base, which would cause premiums to rise.