President Trump has ordered the Department of Labor to “consider” loosening restrictions on association health plans. A leaked copy of the order says that businesses in the same industry would able to “band together” across state lines to offer coverage—something that Trump had flogged as a health-care panacea during the 2016 campaign. In reality, though, this policy would work to undermine the Affordable Care Act’s exchanges and drive up expenses for people with medical conditions:
Here is the Executive Order to undermine the ACA.
— Andy Slavitt (@ASlavitt) October 12, 2017
Long on propoganda. Short on details. Plenty of sabotage. 2/ pic.twitter.com/n64pcEoXfF
As Vox’s Dylan Scott reported on Tuesday, Trump’s plan would allow association health plans “to craft skimpier (and cheaper) health plans that appeal only to businesses with younger and healthier employees.” Some people will save money, in other words, but only as long as they avoid catastrophic illness or disability—meaning that people with pre-existing conditions would be left to rot and/or go bankrupt.
Trump claims this change will support small business owners, but at least one advocacy group isn’t convinced. In a statement to the New Republic, Small Business Majority Founder and CEO John Arensmyer said Trump’s order “would result in the emergence of parallel insurance markets for small businesses, leading to major spikes in premiums for small firms that remain in the small-group market.” Arensmyer added that the plans offered “fewer consumer safeguards” and concluded, “This administration has shown once again that it cannot and will not accept a simple truth: The ACA has helped millions of small business owners, their employees and solo entrepreneurs gain quality, affordable health insurance.”
Of course, any effort to predict the longer-term results of Trump’s executive order presumes that it would survive a legal challenge—something that specialists in health- care policy regard as far from a sure thing. Trump’s plan may violate the U.S. Employee Retirement Income Security Act (better known as ERISA) and therefore would not survive a legal challenge. “The E in ERISA is employee,” the American Enterprise Institute’s Joseph Antos told Reuters. “They are going to have to stretch the definition of whether you’re an employee or not.”
In other words, the order appears to be a classic Trump stunt: His plan combines callous disregard for the sick and vulnerable with shoddy policy that might not even stand up in court. It’s sound and fury, signifying fear; Trump’s trying to shore up his floundering agenda any way he can.
