With Republicans in Congress unable to pass a bill to overhaul the Obama health law, President Donald Trump on Thursday took a first step to force change, approving a series of executive actions which he says will allow Americans to buy less expensive health insurance policies in the future, though the exact details of the new plans from the Trump Administration must still be developed, and won't go into effect immediately.
“I just keep hearing repeal, replace, repeal, replace, and that’s what we’re starting," the President said in a White House ceremony, emphasizing that this announcement takes the "first steps to providing millions of Americans with Obamacare relief.
"Today is only the beginning," the President declared, as he vowed to finish the repeal and replacement of Obamacare, "once and for all."
"This order takes first steps to make it easier for businesses to help their workers afford high quality and more flexible health care," the President added, though the details of how all of this would develop still must be worked out by the feds.
White House officials though stressed that any reforms would be months away, and might not change insurance coverage rules until 2019.
The reason for the delay - the changes offered up by the President would have to go through a regular government rule-making process, which takes time.
In a release, the White House said the moves by the President would "take the first steps to expand choices and alternatives to Obamacare plans and increase competition to bring down costs for consumers."
But the details of the executive actions did not indicate immediate change:
+ The order "directs the Secretary of Labor to consider expanding access to Association Health Plans"
+ The order directs three different cabinet departments "to consider expanding coverage through low cost short-term limited duration insurance" policies. Those short-term plans would not be subject to coverage rules under the Obama health law, and would likely not cover people with pre-existing conditions.
+ The Trump order directs three different cabinet departments "to consider changes to Health Reimbursement Arrangements."
"It's a promise to make changes," said Nicholas Bagley, a law professor at the University of Michigan, who added on Twitter, "it doesn't itself change anything."
"It's a chance for Trump to look like he's doing "something." But he's not, or at least not yet," Bagley added.
In documents released by the White House, there were no specifics offered on buying health insurance across state lines - something touted often by the President and GOP lawmakers - other than saying these moves by Mr. Trump would "potentially allow some employers to join together across State lines to offer coverage."
Sales of health insurance across state lines is already legal under the Obama health law, but few states and companies have engaged in that practice; many state insurance commissioners are not fans of that, either.
Reaction from Republicans and the business community was positive to the President's actions.
"This is what real free market replacement looks like," said Sen. Rand Paul (R-KY).
"Millions of Americans will be eligible to band together to demand less-expensive insurance. The 28 million individuals left behind by Obamacare will now be eligible for inexpensive insurance," Paul said.
"In the wake of the Senate’s failure to repeal Obamacare, we are grateful to President Trump for addressing regulations that make it harder and costlier for small business owners to provide healthcare for themselves and their employees," said Juanita Duggan, the head of the National Federation of Independent Business.
As for Democrats and groups that support the Obama health law, while they were waiting to see the details of what will actually change, their view was simple - that this is an effort to sabotage Obamacare.
"This will sabotage health insurance markets and will be catastrophic for millions of Americans, whose coverage will become more expensive," said Sen. Kirsten Gillibrand (D-NY).
"The executive order envisions loosely regulated plans that offer cheaper and skinnier insurance to those who are healthy," said Larry Levitt, a top executive at the Kaiser Family Foundation.
"Insurers will raise premiums and leave markets," said Andy Slavitt, who oversaw the health law during part of the Obama Administration. "New entrants will be the junk insurance companies that had gone away."
Here is the full Executive Order signed by the President, as released by the White House: