As promised, on his first day in office, President Donald Trump took steps to undo the Affordable Care Act, former President Obama’s signature health care law. In one of his first executive orders, Trump pushed the secretary of Health and Human Services (HHS) and other federal agencies to begin weakening the law. The meaning of the executive order is both subtle and bold; on the one hand, it does very little because it doesn’t grant the administration any powers that it didn’t already have. On the other hand, it signals to the public that change is coming and lets employees at HHS know that they’d better be part of that change.
Section 2 of the order instructs the secretary of HHS to “exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay” parts of the law that would place a fiscal burden on states, individuals or health-care providers. Most of the provisions in the ACA can’t just be changed by HHS or the president; they require action from Congress or a lengthy period involving public comment. Which is why it’s reasonable to assume this line is targeted at the things HHS can change, like the individual mandate. The individual mandate, which requires most people to have health insurance or face a tax penalty, has always been the most contentious part of the law.
At least, that’s how the mandate was interpreted during the Obama administration. In reality, the secretary of HHS can grant hardship exemptions to the mandate as she sees fit. Under the Obama administration, the hardship exemptions were granted to people who earned below 138 percent of the federal poverty limit and lived in states that didn’t expand Medicaid, or experienced a handful of other life circumstances, including homelessness or domestic violence.
But there’s nothing preventing the HHS secretary from granting hardship exemptions to everyone who doesn’t have insurance, rendering the mandate meaningless. If he’s confirmed, Rep. Tom Price, Trump’s pick to lead HHS, could have granted blanket hardship exemptions before the executive order was issued, but in case there was any question, the folks at HHS now have their bosses’ itemized list of priorities.
Read the full blog post here: Trump’s Executive Order On Obamacare Means Everything And Does Nothing | FiveThirtyEight