New Trump Executive Order Treats Health Coverage System Gently

President Donald Trump today signed an executive order that could eventually lead to changes in hospital price disclosure, billing and bill collection practices. The America First Healthcare Plan executive order also discusses the policy of the United States on health coverage access for Americans with pre-existing conditions. The order does not include any provisions that seem likely to lead to big changes in Medicare coverage or commercial health coverage.

Resources

• A copy of the new executive order is available here.
• A video of the president's remarks is available here.
• An article about an earlier Trump administration health cost executive order is available here.

The president traveled to Charlotte, North Carolina, to introduce the executive order. The White House and news organizations streamed the event live on the web. For policy details, see the slideshow above.

The Remarks

The audience at the Charlotte event included Seema Verma, who is the administrator of the Centers for Medicare and Medicaid Services; Alex Azar II, the secretary of the U.S. Department of Health and Human Services (HHS); and Sen. Bill Cassidy, R-La., a senator who has actively courted insurance agent support for his proposals to change or replace the current Affordable Care Act framework for health insurance. (Related: How Dr. Bill Wants to Change Health Insurance Now) Trump told the crowd that he would be laying out a vision for a "health care system that puts patients first, families first, and, perhaps, most importantly for all of us, America, first." Trump said that more than 130 Democrats in Congress have endorsed single-payer health care legislation that would outlaw private health plans. "We're standing up for our people," Trump said. "We're stopping the radical socialists and communists."

The Supreme Court Case

Trump talked briefly about California v. Texas, an Affordable Care Act constitutionality case that has been taken up by the U.S. Supreme Court. "Obamacare is no longer Obamacare, because we worked on it and manage it very well," Trump said. "We stabilized it, got premiums down very substantially... But it's still unacceptable to me, because it's too expensive and doesn't really do the job as well as we could have." Trump said he hopes the Supreme Court will help "end this ill-conceived plan." "If we win, we will have a better and less expensive plan that will always protect individuals with pre-existing conditions," Trump said. "If we lose, what we have is better than the original version of Obamacare, by far. Much better. Much better."

The Executive Order

In the past, the Trump administration has interpreted the text of the Affordable Care Act in ways that have led it to back away from funding some ACA subsidies and programs, but it has complied with the letter of the law. The administration has used past executive orders to try to make it easier for individuals to use short-term health insurance and health reimbursement arrangements (HRAs), and for employers to offer HRAs and association health plans. In the new executive order, Trump calls for HHS to use its own hospital quality website and, possibly, administrative actions to push hospitals to provide clear, complete price information; avoid harsh bill collection tactics; and end the practice of sending out "surprise bills," or bills for out-of-network care sent to patients who could not choose their hospitals, due to medical emergencies, or who received care from out-of-network health care professionals in in-network hospitals. The order does not appear to eliminate or add any provisions that would directly affect 2021 health coverage. The annual enrollment period for Medicare plans for 2021 starts Oct. 15. In much of the country, the open enrollment period for individual major medical coverage for 2021 starts Nov. 1. The executive order could lead to HHS developing surprise billing regulations or guidance in early 2021, and the order could lead to hospital price disclosure and billing practices information showing up on Medicare's Hospital Compare website in late 2021.

The Future

Earlier news reports suggested that Trump wants to send Medicare recipients cash they can use to pay for drugs. Trump said he does intend to do that. "Under my plan, beneficiaries will soon receive a card in the mail containing $200 that they can use to help pay for prescription drugs," Trump said. "Nobody's seen this before. These cards are incredible. The cards will be mailed out in coming weeks. i will always take care of our wonderful senior citizens." Trump said the administration is also working on a proposal for encouraging companies to make medical supplies in the United States. "We will permanently bring our medical supply chains back home," Trump said. "We will produce our medical supplies, pharmaceuticals and treatments right here in North Carolina." — Read What Happens to the Economy and Markets After the Election?, on ThinkAdvisor. — Connect with ThinkAdvisor Life/Health on Facebook, LinkedIn and Twitter.