# Trump's Executive Order on Health Care: what's the deal? **URL:** \ **Category:** Politics & Elections\ **Created:** [October 12, 2017, 7:45pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673 "2017-10-12T19:45:38Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [October 12, 2017, 7:45pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/1 "2017-10-12T19:45:38Z")
[Trump signed a health care order today](https://apnews.com/6bd0957a72084d579a0e053ea0b70030/Calling-it-a-beginning,-Trump-signs-health-care-order). > [@](#): > > Frustrated by health care failures in Congress, President Donald Trump directed his administration Thursday to rewrite some federal insurance rules as a beginning of renewed efforts to undermine “Obamacare,” the program he’s promised to kill. > > “With these actions, we are moving toward lower costs and more options in the health care market,” Trump said before signing his directive in the Oval Office. Trump said he will continue to pressure Congress to repeal and replace former President Barack Obama’s Affordable Care Act. The effects of the new policies are debatable, apparently: > [@](#): > > Some experts said the White House plan could undermine coverage on the ACA’s insurance marketplaces, particularly for people with health problems. That would happen if healthy people flock to lower-cost plans with limited benefits. > > Other experts said Trump’s proposals appear to be modest and would have limited impact. But no one seems to think anything is going to change anytime soon due to this EO. > [@](#): > > The steps the president outlined Thursday will take months for the federal bureaucracy to finalize in regulations. Experts said consumers should not expect changes for next year. The AP story mentions several points of the plan: > [@](#): > > —Easing current restrictions on short-term policies that last less than a year, an option for people making a life transition, from recent college graduates to early retirees. Those policies are not subject to current federal and state rules that require standard benefits and other consumer protections. > > —Allowing employers to set aside pre-tax dollars so workers can use the money to buy an individual health policy. I’m not sure what I think about those things. Two characterizations: > [@](#): > > On Capitol Hill, House Democratic Leader Nancy Pelosi said Trump “knows very little” about health care policy or legislation. She said she was unfamiliar with the details of the executive order, “but I do know it’s a sabotage of the Affordable Care Act.” > [@](#): > > But Sen. John Barrasso, R-Wyo, said Trump is taking “bold action” to give patients “the freedom and flexibility to choose the health care plan that works best for them.” Which is it? Is it both? Is it neither? What’s the deal? ---
**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\ **Post date:** [October 12, 2017, 8:03pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/2 "2017-10-12T20:03:53Z")
I’m no expert on this, but I did read a little about it on my lunch break. The short version is that people who are likely not to need insurance soon will find it easier to get bare bones plans, and those who will actually need to use insurance soon are about to be price gouged and fucked. How unexpected. ---
**Author:** ![Aufgeblassen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aufgeblassen/32/7321_2.png) [@Aufgeblassen](https://boards.straightdope.com/u/Aufgeblassen)\ **Post date:** [October 12, 2017, 8:04pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/3 "2017-10-12T20:04:09Z")
The deal is that it is better than nothing! 😃 ---
**Author:** ![enipla](https://avatars.discourse-cdn.com/v4/letter/e/54ee81/32.png) [@enipla](https://boards.straightdope.com/u/enipla)\ **Post date:** [October 12, 2017, 8:19pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/4 "2017-10-12T20:19:29Z")
Trump is just screwing people that have health problems. And those that think they are healthy, but BOOM along comes the big ‘C’ or something and they will be screwed too. Trump knows NOTHING about any type of insurance. He’s just showing once again what a racist idiot he is. All he wants to do is sabotage the ACA because Obama put it in place. ---
**Author:** ![RickG](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rickg/32/5174_2.png) [@RickG](https://boards.straightdope.com/u/RickG)\ **Post date:** [October 12, 2017, 8:23pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/5 "2017-10-12T20:23:46Z")
My go-to on healthcare policy is [Vox.com](https://www.vox.com/policy-and-politics/2017/10/12/16458184/trump-obamacare-executive-order-association-health-plans-short-term-insurance). That link has a good explainer on association plans and the potential effect of putting them under the rules of large businesses (as opposed to small), and also letting self-employed people (some of the biggest users of the individual markets) into those association plans. The upshot is a potential death-spiral in the individual markets, which would effectively end that part of the ACA without congress needing to explicitly repeal it. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [October 12, 2017, 11:38pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/6 "2017-10-12T23:38:52Z")
> [@](#): > > The AP story mentions several points of the plan: > > > [@](#): > > > > …—Allowing employers to set aside pre-tax dollars so workers can use the money to buy an individual health policy. This point is appealing to that very small business sector that does not have enough employees to be required to provide coverage per the ACA. Larger businesses effectively get to provide employee benefits with pre-tax dollars. This proposal would allow those very small businesses to do the same without incurring some of the issues related to [section 105 plans](https://www.zanebenefits.com/blog/section-105-plans-for-dummies) which is how they would have to do this now. Actually a reasonable idea. ---
**Author:** ![WillFarnaby](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/willfarnaby/32/514_2.png) [@WillFarnaby](https://boards.straightdope.com/u/WillFarnaby)\ **Post date:** [October 13, 2017, 2:51am UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/7 "2017-10-13T02:51:00Z")
This is the only way health care policy should be reformed. Incremental steps toward capitalism. A master stroke by Rand Paul. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [October 13, 2017, 4:43am UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/8 "2017-10-13T04:43:47Z")
> [@WillFarnaby](#): > > This is the only way health care policy should be reformed. Incremental steps toward capitalism. A master stroke by Rand Paul. With a system that the home market of 2008 would be proud of. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [October 13, 2017, 12:09pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/9 "2017-10-13T12:09:47Z")
Those that have, live. Those that don’t, die. Has Rand Paul ever been poor enough not to be able to afford his own health care? ---
**Author:** ![Dereknocue67](https://avatars.discourse-cdn.com/v4/letter/d/6de8d8/32.png) [@Dereknocue67](https://boards.straightdope.com/u/Dereknocue67)\ **Post date:** [October 13, 2017, 12:23pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/10 "2017-10-13T12:23:30Z")
Trump has adopted the herd mentality on health care. If a member of an animal herd is sick or injured, the herd abandons it and leaves it behind, usually to die. Trump is using the same approach to health care and is culling the population of what he may believe is excess weight. He can do this because after all, in his mind, he’s the smartest guy on the planet. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [October 13, 2017, 12:54pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/11 "2017-10-13T12:54:57Z")
> [@WillFarnaby](#): > > This is the only way health care policy should be reformed. Incremental steps toward capitalism. A master stroke by Rand Paul. And having thousands of people die as a result is a feature, not a bug. Rand Paul doesn’t give a damn about anything but his morally bankrupt libertarian philosophy. He must have a strong stomach, standing next to Dumb Donald who proudly holds up a signed order with the same expression as a two year old who just went on the potty by himself. This is a sickening day, literally, for the US. ---
**Author:** ![Doctor\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctor_jackson/32/32_2.png) [@Doctor\_Jackson](https://boards.straightdope.com/u/Doctor_Jackson)\ **Post date:** [October 13, 2017, 1:38pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/12 "2017-10-13T13:38:44Z")
The main pushback I’ve heard so far is that this EO will drive the young and healthy out of the exchanges and into these new, cheaper (with less coverage) plans and, thereby, raise rates for the older, sicker segment of the population. [The fact is that the young and healthy never signed up for ACA in any significant numbers](http://www.modernhealthcare.com/article/20160514/MAGAZINE/305149980). A large percentage decided to do without insurance all together. > [@](#): > > The most significant factor behind next year’s sharply rising prices, experts say, is that millions of “young invincibles,” who represent a large segment of the uninsured pool, have so far not signed up for Obamacare. and > [@](#): > > Indeed, only 28% of exchange members in 2014 were in the coveted 18-34 age range, and that percentage stayed level for 2016. It’s below the 40% level many actuaries say is needed to create a more stable rate environment. The insurance industry has a name for that condition, which Obamacare was designed to fight. It’s called adverse selection. And so far, the ACA’s medicine isn’t working. In my mind, it’s the young & healthy who are currently uninsured who will go for the proposed plans. ACA may lose a few of that demographic, but there really aren’t enough out there to make the numbers work anyway. Only 45% of the total US population is under age 35 (age 0-34), yet actuaries say the ACA pool needs to have 40% of participants be in that age group. In reality, that 40% would come mostly from those in the 26-35 age bracket, which is only 12% of the US population. ACA, as implemented, is unsustainable. Where the ACA pool may be (I have seen no numbers one way or the other yet) affected most is by the association insurance provision. This will let small businesses band together to offer insurance to their employees at group prices, which are most often lower than exchange prices. This will no doubt draw people away from the exchanges, but the mix of healthy vs not healthy is unclear. I’m going to wait until I see more data before I decide whether this is good, bad or indifferent. ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [October 13, 2017, 1:49pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/13 "2017-10-13T13:49:15Z")
The problem is, if you’re an insurance company, how do you price your premiums for ACA recipients? Sure, the law still exists on paper, but you also have a president who is eliminating requirements that encourage (or push, depending on your leanings) people to participate in the marketplace. Meanwhile, he’s removing subsidies to help people who fall into more expensive care brackets. In effect, Obamacare’s red tape, though complicated, was actually getting people to sign up for that care. But Trump has signed Obamare’s death warrant and it’s probably irreversible. What this means is that we’ll probably go back to the way it was in 2008. A bunch of cheap skate policies that pay absolutely nothing if you actually do end up getting sick, and nothing to control the costs of healthcare or health insurance. The people who get real medical insurance will probably get it through their employer, but if they’re disabled and can’t work… ---
**Author:** ![SingleMalt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/singlemalt/32/3961_2.png) [@SingleMalt](https://boards.straightdope.com/u/SingleMalt)\ **Post date:** [October 13, 2017, 6:23pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/14 "2017-10-13T18:23:25Z")
> [@Doctor\_Jackson](#): > > The main pushback I’ve heard so far is that this EO will drive the young and healthy out of the exchanges and into these new, cheaper (with less coverage) plans and, thereby, raise rates for the older, sicker segment of the population. [The fact is that the young and healthy never signed up for ACA in any significant numbers](http://www.modernhealthcare.com/article/20160514/MAGAZINE/305149980). A large percentage decided to do without insurance all together. > > … > In my mind, it’s the young & healthy who are currently uninsured who will go for the proposed plans. ACA may lose a few of that demographic, but there really aren’t enough out there to make the numbers work anyway. Only 45% of the total US population is under age 35 (age 0-34), yet actuaries say the ACA pool needs to have 40% of participants be in that age group. In reality, that 40% would come mostly from those in the 26-35 age bracket, which is only 12% of the US population. ACA, as implemented, is unsustainable. > > Where the ACA pool may be (I have seen no numbers one way or the other yet) affected most is by the association insurance provision. This will let small businesses band together to offer insurance to their employees at group prices, which are most often lower than exchange prices. This will no doubt draw people away from the exchanges, but the mix of healthy vs not healthy is unclear. > > I’m going to wait until I see more data before I decide whether this is good, bad or indifferent. This is a very interesting point, the consequences of which could backfire. These “less coverage” plans may actually encourage enrollment in the ACA by the young and healthy who would otherwise be non-enrollees. Thus, higher total participation in the ACA than previously. Also, the subsidies for the lower-income participants are based on the participant’s income, not the cost of the coverage (iirc). If the rates go up, the subsidies will also go up, meaning the taxpayers will be picking up the difference. The people who will be hurt are those above the subsidy line, who could end up paying substantially more for their coverage. Who knew unintended consequences could be so complicated? ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [October 13, 2017, 7:03pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/15 "2017-10-13T19:03:57Z")
> [@asahi](#): > > The problem is, if you’re an insurance company, how do you price your premiums for ACA recipients? Sure, the law still exists on paper, but you also have a president who is eliminating requirements that encourage (or push, depending on your leanings) people to participate in the marketplace. Meanwhile, he’s removing subsidies to help people who fall into more expensive care brackets. In effect, Obamacare’s red tape, though complicated, was actually getting people to sign up for that care. But Trump has signed Obamare’s death warrant and it’s probably irreversible. That is my thought exactly, even under the best scenario where none of his tweeted policy statements never go anywhere, the tweets raise uncertainty in the future of the health care markets, and the mere existence of this uncertainty may be sufficient to severely wound ACA. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [October 13, 2017, 8:42pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/16 "2017-10-13T20:42:19Z")
“Severely wound”? Indeed, the point of the dagger is the point of the exercise. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [October 13, 2017, 9:27pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/17 "2017-10-13T21:27:41Z")
> [@Dereknocue67](#): > > Trump has adopted the herd mentality on health care. If a member of an animal herd is sick or injured, the herd abandons it and leaves it behind, usually to die… No Trump has adopted the mentality of a toddler (actually it appears he has the mentality of a toddler), if he can’t have it his way he will try to destroy it and make people miserable. I wanted someone with a heart of a child to be the leader, not the mind of one :rolleyes: :smack: ---
**Author:** ![snowthx](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowthx/32/10660_2.png) [@snowthx](https://boards.straightdope.com/u/snowthx)\ **Post date:** [October 13, 2017, 9:39pm UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/18 "2017-10-13T21:39:15Z")
I don’t have anything to add to what has already been said here. It seems Trump and his supporters are only interested in one thing, and one thing only - “do whatever it takes to make the lib’ruls mad”. Roll back sound, bipartisan policy achievements from the prior administration, say and do things inconceivable for a leader, bully anyone who does not bow down to the Emperor. It does not matter if it is bad for the world, bad for the nation, or bad for them as individuals - if it makes liberals crazy mad, then they are all for it. ☹ ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [October 14, 2017, 12:21am UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/19 "2017-10-14T00:21:52Z")
> [@kanicbird](#): > > No Trump has adopted the mentality of a toddler (actually it appears he has the mentality of a toddler), if he can’t have it his way he will try to destroy it and make people miserable. > > I wanted someone with a heart of a child to be the leader, not the mind of one :rolleyes: :smack: Part of Trump just takes satisfaction in destroying Barack Obama’s legacy. Trump made an ass of himself with his birth certificate conspiracies, and Obama went on to get re-elected and ended up having a little fun at his expense at the press corps roast or whatever it’s called. Trump has been waiting to put ‘uppity’ Obama in his place for years, and this is his chance to do it. And he’s doing it. He’s not going to stop there either. Whatever Obama did, he will undo; whatever Obama didn’t do, he will do. From free trade to nuclear weapons deals to criminal justice reform, Trump is the anti-Obama. But more to the point, it’s worth repeating that Trump can’t create anything. He can’t develop anything. He can’t produce. He can only destroy. He never built hotels; he just found ways to scam other people into doing it for him and then taking their money - why else would he need to scam contractors? Good businessmen don’t do that - don’t need to. Trump is just a destroyer. And he will continue to just walk in the shop and break stuff until he’s either impeached or voted out of office. And the longer he stays, he’s going to find more expensive stuff to break. ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [October 14, 2017, 2:34am UTC](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673/20 "2017-10-14T02:34:19Z")
> [@asahi](#): > > The people who get real medical insurance will probably get it through their employer, but if they’re disabled and can’t work… The disabled can get it through Medicare, right? [Next page](https://boards.straightdope.com/t/trumps-executive-order-on-health-care-whats-the-deal/798673.md?page=2)