Trump Signs Executive Order to Ease Burden of Obamacare

[STIBROKER]

On first day, Donald Trump signs health care executive order to ‘ease burden of Obamacare’ | The Indian Express

President Donald Trump has signed his first executive order as president, ordering federal agencies to ease the burden of President Barack Obama’s sweeping health care law.Trumpcare Health Insurance Texas Rates

 

[HealthBroker]

"Faith is the SUBSTANCE of things hoped for, the EVIDENCE of things not seen."
To all of you Health Agents that have hung in there . . . your faith has brought you thru. It's been a difficult road at best . . .but we need to continue work hard and keep the Faith. We will not just survive but Thrive. There are many Great Leaders on this Forum . . . I want to thank them for taking the time to guide and encourage us to hang in there and see it thru. This is a great resource and I for one appreciate it. Thank You and lets have a great year!!!

 

[Monti_Ray]

What does this mean? No more penalties? States can go their way?

https://www.facebook.com/ABCNews/ph...86680728811/10155285949483812/?type=3&theater

Monti

Exclusive Health Insurance Leads

 

[BYSFG]

Sounds like higher premiums. Time to get in the health care business?

 

[Yagents]

Funny, I haven't received on solicitation from HC.gov to sign up for ACA.

Not one text, call or email VS 5 a day.

An example of agencies backing off from executive order?

 

[Ann H]

The fact that he issued this order FIRST, and during inauguration celebrations is telling.

However, these Executive orders are normal when an opposing party takes office. ALL Presidents have done this when taking office. They freeze executive orders that are in process and are not yet implemented, so they can reroute them in the direction of the new administration's goals. That's the Executive Order freeze that Trump signed. Then, they also instruct Department heads on how to handle current rules/regs that are within their power to interpret and manipulate. You notice it most when an opposing party takes office, and you notice it even more when the new party's goals are at enormous odds with the prior party. So, for instance, an anti-war President taking over from a pro-war President will make news by issuing an executive order that freezes rule-making and that eases the current rules/regs on those issues.

Then the rest of it comes later. What comes later are repeals, delays and waivers of rules/regs that are already enacted. Delays and waivers are first. Repeals of enacted rules/regs take longer. So, for instance, Trump just allowed the Department head of the Treasury Dept (of which the IRS is a branch) to ease the burden/cost of certain rules/regs that are already implemented. If the IRS/Treasury wishes, they can declare that they will not enforce the individual mandate penalty. They may do so quickly. They may take their time in doing so, because it will cause immediate adverse selection, and possible carrier withdrawal from the market. That might be what they want. CMS could issue a waiver saying carriers can withdraw without penalty. So, if that is what they want, IRS and CMS will do it together. If preserving the fragile market until a replacement system is in order is what they want, then they will take their time waiving the penalty until they can prop up a falling market. Or they might give more hardship exemptions, which partially waives the penalty for now. It really depends on their goals. Right now we know their big goal, but some of this is about the sub-goals inside the big goals.

What comes soon will be bigger news as we see how they coalesce around goals.

So, the administration is allowed to "WAIVE" or "DELAY ENFORCEMENT" of a rule. They can alter the way they interpret rules/regs. There are many laws, rules & regs about which the government simply turns their head and doesn't look. An example is CMS and the SEP rules. It was law, it was in the rules/regs, but hc.gov would give out an SEP for anything, and didn't care. Then, later when insurance companies cried loudly, CMS decided to pay attention to the rule/reg and they didn't "look the other way" as much.

REPEALING a rule/reg takes a little longer. They cannot change a rule/reg that is already published with the Federal Register and is past its enactment date. What they do with those rules is go through the process of re-evaluation. So, for instance, take the short-term policy's 3 month limit rule. It has been published, but not enacted until April. Take the Fixed Indemnity rule. It has been published AND enacted. So, the short-term rule could be halted before enactment. The Fixed Indemnity rule must be repealed. The process to repeal a rule/reg is to 1) Issue a proposed rule; 2) open it for comments for a stated time; 3) Issue a Final Rule; 4) Publish it; 5) File it with the Federal Register; 6) Enact it on the date that it says is the enactment date.

That doesn't mean that an enacted rule cannot be manipulated by WAIVER, DELAYING ENFORCEMENT, reinterpreting it and ignoring it. Take "delaying enforcement" for instance. To delay enforcement, there must be a penalty to delay enforcement about. So, for instance the Fixed Indemnity and Short-Term rules have no penalty. But the individual mandate has a penalty. The individual mandate is not actually a rule/reg. It is a part of the ACA law itself. But the ACA law gave enforcement rights to the IRS. The IRS can voluntarily delay enforcement of a penalty. They've done it before, many times. For instance, there are non-discrimination rules written in the ACA law that apply to groups, yet the enforcement has been delayed from the outset of the law and has never been enforced. In fact, they issued a statement saying that enforcement was delayed INDEFINITELY. But to delay enforcement, you have to look at rules/regs that have a penalty to delay enforcement about. The individual mandate is a prime example. So, is the group reporting requirements and penalties. The group reporting requirements and penalties might actually be axed faster, just because they do not cause a market to crash and the reporting requirements are imminent - they are this spring.

It's important to know what is a rule/reg and what is a law. The administration right now is only able to make changes that are in the rules/regs under which the Secretaries of these Departments have been given authority or in enforcement of penalties or burdens of cost for portions of the law over which they have authority. There are lots of things that they can do with these rules/regs, penalties, costs and enforcement. There are things they cannot do.

They cannot change the law without a bill that passes both houses of Congress and is signed by the President. So, for instance, Guaranteed Issue won't change immediately because it is in the law and not subject to rules/regs or delayed enforcement. I do take note that the Executive Order gave more power to states to control their own markets. The states might find loopholes and might find ways to work around Guar Issue. However, they may not want to use those loopholes right now because it will cause a market to crash. Arizona actually has more of a chance of using those loopholes because we already have a crashed market that has 2% possibility of surviving to 2018. There are loopholes right now. ERISA plans (Level Funded, Self Funded etc.) are examples. Short-term plans are examples. But real, true removal of guaranteed issue laws takes more than just an executive order, because it is written in the law itself and not just subject to rules/regs, delays of enforcement, waivers or reinterpretation. The power given to the states was probably more about Medicaid than anything else, but we shall see.

Another thing they can do is defund. The House controls the purse strings, but departments are given funds to dole out to projects as they see fit. They can move the money around from one project to another, effectively disabling a project in its tracks. Healthcare.gov funding might be axed. It will be interesting to see what defunding choices they make.

Another thing they can do is to use the judicial branch. A quick example is the CSR funding. Currently President Obama's administration was appealing the judge's decision, but President Trump's administration can drop their appeal. That would make the CSR funding issue crash to the floor. This would be an indication that they don't care about the burden on insurers, insurer withdrawal, etc. Or, that they don't care about a crashing market. They may not care for several valid reasons, one of which is because they have a replacement plan ready, or other funding mechanisms to replace the CSR funding mechanisms during the transition. They might even agree with the judge for a delayed enactment date of the damage to CSR funding. What they do next is very telling about where they intend to end up.

This is a dance that could move across the dance floor in multiple ways. It will be interesting to see what end-goals they are coalescing around. Expect the Department heads' actions to give us a clue about what kind of repeal/replace is coming. If the IRS delays enforcement of the individual mandate, we know several things. Possibly they don't care about adverse selection. Possibly they don't care if the market crashes. Possibly they have a replacement system ready to go before the market crashes. But this Executive Order was just paving the way to move into a certain direction. The big news is coming next, because what they do next will be key indicators of the particulars in their plan.

 

[Monti_Ray]

Thanks for the in-depth analysis. I hope, the government talks to the talents we have in this forum.

The fact that he issued this order FIRST, and during inauguration celebrations is telling.

However, these Executive orders are normal when an opposing party takes office. ALL Presidents have done this when taking office. They freeze executive orders that are in process and are not yet implemented, so they can reroute them in the direction of the new administration's goals. That's the Executive Order freeze that Trump signed. Then, they also instruct Department heads on how to handle current rules/regs that are within their power to interpret and manipulate. You notice it most when an opposing party takes office, and you notice it even more when the new party's goals are at enormous odds with the prior party. So, for instance, an anti-war President taking over from a pro-war President will make news by issuing an executive order that freezes rule-making and that eases the current rules/regs on those issues.

Then the rest of it comes later. What comes later are repeals, delays and waivers of rules/regs that are already enacted. Delays and waivers are first. Repeals of enacted rules/regs take longer. So, for instance, Trump just allowed the Department head of the Treasury Dept (of which the IRS is a branch) to ease the burden/cost of certain rules/regs that are already implemented. If the IRS/Treasury wishes, they can declare that they will not enforce the individual mandate penalty. They may do so quickly. They may take their time in doing so, because it will cause immediate adverse selection, and possible carrier withdrawal from the market. That might be what they want. CMS could issue a waiver saying carriers can withdraw without penalty. So, if that is what they want, IRS and CMS will do it together. If preserving the fragile market until a replacement system is in order is what they want, then they will take their time waiving the penalty until they can prop up a falling market. Or they might give more hardship exemptions, which partially waives the penalty for now. It really depends on their goals. Right now we know their big goal, but some of this is about the sub-goals inside the big goals.

What comes soon will be bigger news as we see how they coalesce around goals.

So, the administration is allowed to "WAIVE" or "DELAY ENFORCEMENT" of a rule. They can alter the way they interpret rules/regs. There are many laws, rules & regs about which the government simply turns their head and doesn't look. An example is CMS and the SEP rules. It was law, it was in the rules/regs, but hc.gov would give out an SEP for anything, and didn't care. Then, later when insurance companies cried loudly, CMS decided to pay attention to the rule/reg and they didn't "look the other way" as much.

REPEALING a rule/reg takes a little longer. They cannot change a rule/reg that is already published with the Federal Register and is past its enactment date. What they do with those rules is go through the process of re-evaluation. So, for instance, take the short-term policy's 3 month limit rule. It has been published, but not enacted until April. Take the Fixed Indemnity rule. It has been published AND enacted. So, the short-term rule could be halted before enactment. The Fixed Indemnity rule must be repealed. The process to repeal a rule/reg is to 1) Issue a proposed rule; 2) open it for comments for a stated time; 3) Issue a Final Rule; 4) Publish it; 5) File it with the Federal Register; 6) Enact it on the date that it says is the enactment date.

That doesn't mean that an enacted rule cannot be manipulated by WAIVER, DELAYING ENFORCEMENT, reinterpreting it and ignoring it. Take "delaying enforcement" for instance. To delay enforcement, there must be a penalty to delay enforcement about. So, for instance the Fixed Indemnity and Short-Term rules have no penalty. But the individual mandate has a penalty. The individual mandate is not actually a rule/reg. It is a part of the ACA law itself. But the ACA law gave enforcement rights to the IRS. The IRS can voluntarily delay enforcement of a penalty. They've done it before, many times. For instance, there are non-discrimination rules written in the ACA law that apply to groups, yet the enforcement has been delayed from the outset of the law and has never been enforced. In fact, they issued a statement saying that enforcement was delayed INDEFINITELY. But to delay enforcement, you have to look at rules/regs that have a penalty to delay enforcement about. The individual mandate is a prime example. So, is the group reporting requirements and penalties. The group reporting requirements and penalties might actually be axed faster, just because they do not cause a market to crash and the reporting requirements are imminent - they are this spring.

It's important to know what is a rule/reg and what is a law. The administration right now is only able to make changes that are in the rules/regs under which the Secretaries of these Departments have been given authority or in enforcement of penalties or burdens of cost for portions of the law over which they have authority. There are lots of things that they can do with these rules/regs, penalties, costs and enforcement. There are things they cannot do.

They cannot change the law without a bill that passes both houses of Congress and is signed by the President. So, for instance, Guaranteed Issue won't change immediately because it is in the law and not subject to rules/regs or delayed enforcement. I do take note that the Executive Order gave more power to states to control their own markets. The states might find loopholes and might find ways to work around Guar Issue. However, they may not want to use those loopholes right now because it will cause a market to crash. Arizona actually has more of a chance of using those loopholes because we already have a crashed market that has 2% possibility of surviving to 2018. There are loopholes right now. ERISA plans (Level Funded, Self Funded etc.) are examples. Short-term plans are examples. But real, true removal of guaranteed issue laws takes more than just an executive order, because it is written in the law itself and not just subject to rules/regs, delays of enforcement, waivers or reinterpretation. The power given to the states was probably more about Medicaid than anything else, but we shall see.

Another thing they can do is defund. The House controls the purse strings, but departments are given funds to dole out to projects as they see fit. They can move the money around from one project to another, effectively disabling a project in its tracks. Healthcare.gov funding might be axed. It will be interesting to see what defunding choices they make.

Another thing they can do is to use the judicial branch. A quick example is the CSR funding. Currently President Obama's administration was appealing the judge's decision, but President Trump's administration can drop their appeal. That would make the CSR funding issue crash to the floor. This would be an indication that they don't care about the burden on insurers, insurer withdrawal, etc. Or, that they don't care about a crashing market. They may not care for several valid reasons, one of which is because they have a replacement plan ready, or other funding mechanisms to replace the CSR funding mechanisms during the transition. They might even agree with the judge for a delayed enactment date of the damage to CSR funding. What they do next is very telling about where they intend to end up.

This is a dance that could move across the dance floor in multiple ways. It will be interesting to see what end-goals they are coalescing around. Expect the Department heads' actions to give us a clue about what kind of repeal/replace is coming. If the IRS delays enforcement of the individual mandate, we know several things. Possibly they don't care about adverse selection. Possibly they don't care if the market crashes. Possibly they have a replacement system ready to go before the market crashes. But this Executive Order was just paving the way to move into a certain direction. The big news is coming next, because what they do next will be key indicators of the particulars in their plan.

 

[LGilmore]

Don't be surprised if carriers start pulling out of the individual market. The mandate was an industry requirement to play. Taking that away first will cause many to suspend product sales.

In 1994 when my state adopted the Clinton plan, we had an exodus of carriers who simply did not want to go guaranteed issue with no underwriting.

So having gone through this once before, I do expect it again. Right now, it throws the carriers numbers out the window. It is much safer to remove themselves from the market and sit on what they have then to continue to take on new business.

Don't surprised in a month or two there isn't a product to sell while the government works things out.

The mandate is what insurance companies wanted to participate. As it sits right now you're cheering to have less business and have existing business drop off. I expect some of my exchange business to drop off, even those with premium help. If this reorganization carries on into next year I expect renewals to be significant without the mandate. Most carriers do group or other products, individual medical is not a huge money maker for most. They'll just sit out things till it sorts out. In WA when it happened it was about 4 years before more than a couple vendors came back. Some never did.

 

[Ann H]

Don't be surprised if carriers start pulling out of the individual market. The mandate was an industry requirement to play. Taking that away first will cause many to suspend product sales.

In 1994 when my state adopted the Clinton plan, we had an exodus of carriers who simply did not want to go guaranteed issue with no underwriting.

So having gone through this once before, I do expect it again. Right now, it throws the carriers numbers out the window. It is much safer to remove themselves from the market and sit on what they have then to continue to take on new business.

Don't surprised in a month or two there isn't a product to sell while the government works things out.

The mandate is what insurance companies wanted to participate. As it sits right now you're cheering to have less business and have existing business drop off. I expect some of my exchange business to drop off, even those with premium help. If this reorganization carries on into next year I expect renewals to be significant without the mandate. Most carriers do group or other products, individual medical is not a huge money maker for most. They'll just sit out things till it sorts out. In WA when it happened it was about 4 years before more than a couple vendors came back. Some never did.

Thank you LGilmore for the insight. You have walked through this before. One thing I am certain of, and that is the support that comes from this forum of talented, experienced and brilliant people who can help each other see ahead in the fog. Thank-you.

 

[STIBROKER]

One thing I am certain of, and that is the support that comes from this forum of talented, experienced and brilliant people who can help each other see ahead in the fog. Thank-you.

What would be the numbers on people dropping ACA plans for STM seeing as how the penalty is gone...........