Conversation, some confusion follow Trump’s executive order on Obamacare

Human resources and benefit managers are among those closely watching what might happen with the Affordable Care Act.
Offices around the country are still working on the implementation of directives ordered under Obamacare, and they are working under deadlines set down under the act. But the executive order signed by President Donald Trump this week has caused some conversation, and a little confusion, as to what will happen next.
J.D. Piro, who leads Aon’s health legal group, said the immediate impact on employer health plans is not clear.
“While the executive order states that the “prompt repeal” of the ACA is the policy of the Trump Administration, the immediate impact of the executive order on employers and employer group health plans is not entirely clear,” Piro told HR Daily Wire.
He said most of the ACA provisions affecting employers and employer group health plans have already gone into effect, and the process of rescinding regulations implementing those provisions would have to go through the standard administrative process of a notice and comment period.
“We believe employers are unlikely to see any immediate relief from the ACA’s current regulatory obligations,” Piro said. “It is unclear to what extent the executive agencies have the authority to waive, defer, exempt or delay implementing laws passed by Congress and already in effect.”
He said such laws include the employer shared responsibility mandate, its reporting rules, and associated penalties.
“Eliminating those rules and penalties from the law would require Congressional action,” Piro said. “In the meantime, the agencies might have more flexibility to lessen the impact of ACA provisions such as the individual mandate, where the law gives the agencies broader discretion to adopt exemptions.”
Some provisions of the ACA have not been implemented, include the nondiscrimination rules for fully insured medical plans and the 40 percent excise tax on high cost health plans, the so-called “Cadillac tax”.
“The executive order makes it highly unlikely that regulations implementing these provisions will be released in the near future,” Piro said.
The executive order also directs departments and agencies “to provide greater flexibility to States and cooperate with them in implementing health care programs” and to “encourage the development of a free and open market in interstate commerce for the offering of health care services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.”
“This might encourage the agencies to approve greater state experimentation with Medicaid expansion, although its impact on the sale of health sale insurance across state lines is unclear,” Piro said.