President Donald Trump on Friday issued an order to government agencies to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.
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The one-page order, which Trump signed in a hastily arranged Oval Office ceremony shortly before departing for the inaugural balls, gave no specifics about which aspects of the law he wanted to target. But its broad language gave federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drugmakers, doctors, states or patients, suggesting that it could have wide-ranging impact, essentially allowing the dismantling of the law to begin even before Congress moves to repeal it.
The order states what Trump made clear during his campaign: that it would be his administration’s policy to seek the “prompt repeal” of the health insurance law, known as Obamacare. But he and Republicans on Capitol Hill have not yet devised a replacement, making such action unlikely in the immediate term.
“In the meantime,” the order said, “pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the act, and prepare to afford the states more flexibility and control to create a more free and open health care market.”
The order has symbolic as well as substantive significance, allowing Trump to claim he acted immediately to do away with a health care law he has repeatedly called disastrous, even while it remains in place and he navigates the politically perilous process of repealing and replacing it.
Using the phrase, “to the maximum extent permitted by law,” the order directs federal agencies to move decisively to implement changes, including granting flexibility that insurers and states had long implored the Obama administration to provide.
It also orders agencies to encourage the creation of a system that allows the sale of health insurance across state lines, which Republicans have long proposed as the centerpiece of an alternative to Obamacare.
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