As insurers flee Obamacare markets around the country, and costs and premiums skyrocket, President Donald Trump on Thursday took executive action to allow individuals to form associations and purchase health insurance across state lines.
Obamacare was implemented largely through executive fiat and a mountain of punishing regulations totaling over 20,202 pages. Many of Obamacare’s most controversial strictures, like the contraceptive mandate, were issued through rulings by the Department of Health and Human Services (HHS), and therefore are subject to a long public hearing process before they can be changed. Trump’s executive order provides a fitting end-run around that.
For months, Sen. Rand Paul (R-Ky.) advocated this free-market solution for Obamacare, and Sen. Paul’s staff worked closely with Trump’s cabinet on the order. According to Paul, health care associations will enable collective bargaining and therefore bring down premium prices.
“Many of the 28 million people left behind by Obamacare who still don’t have insurance work low-wage jobs in our fast food restaurants,” wrote Paul in an op-ed at Breitbart on Thursday. “The President’s decision today will allow workers from 2 million restaurants to come together to form a buying group and through sheer size get cheaper and better insurance.”
“Currently, about half of private insurance is cross-state, self-insured ERISA plans, and most employees love them,” the senator noted. “The President’s action today will allow the millions of people in the individual market an escape route to group insurance.”
Health associations like those authorized by this order will ensure that those with pre-existing conditions are able to maintain access to care, proponents argue. The leverage provided through collective bargaining will lead to lower prices and better coverage for all.
“As a career physician, I know Obamacare is broken and must be repealed. I will keep fighting for this,” Paul wrote. “But I also know health care was broken before Obamacare, and we should take every opportunity to fix what we can.”
There are other executive actions that Trump could take that would hasten the demise of Obamacare, but until today, his administration has been hesitant to do so. Federal courts have ruled that Obamacare’s cost-sharing subsidies are unconstitutional, but so far the Trump administration has continued to pay them anyway. If the president decided to withdraw these subsidies, deductible and out-of-pocket costs for low-income Americans would rise exponentially. Trump could also end the taxpayer subsidy of Congress’s health care, which amounts to around $12,000 per employee.
Health care spending constitutes a historic high of almost 18 percent of U.S. gross domestic product, and dramatically rising prices across the board affect all taxpayers, because the biggest payer in the health care industry is the federal government.
Republican bills to repeal and replace Obamacare this year had many flaws, including that they continued Obamacare subsidies, thereby increasing the national debt.
It is a massive failure of Congressional Republicans that they were unable to fulfill their promise to repeal and replace “Affordable” Care Act. Trump’s executive order begins to make good on Republican pledge to undo the damage wrought by Obamacare by opening up the insurance market and lowering prices, increasing access to coverage for all.