ACA Executive Order: Now what?

Last Friday, President Trump signed an ACA-related executive order directing government agencies to start alleviating the “burden” of the legislation. The executive order mainly serves as a statement of the President’s intent to repeal and replace the ACA. It’s important to note that the law continues to exist and has not been changed.

The executive order does:

  • Direct government agencies of the Executive Branch to begin changing ACA regulation to the extent permitted by law (e.g., continue to follow the Administrative Procedure Act)
  • Require new regulations to be approved by the administration prior to implementation
  • Challenge the incoming Secretaries of HHS, Treasury and Labor to ease said “burdens” of the ACA — but, until these positions are confirmed, no action can be taken

The executive order does not:

  • Repeal or replace legislation
  • Make any direct, tangible changes to the law or regulations

To repeal or replace the legislation, the President will need help from Congress. Here’s our recap of the current situation:

Messages around timing and scope of changes continue to evolve. Congress may have enough votes to repeal parts of the ACA through the budget reconciliation process. But, the President and some Republican leaders have indicated they will repeal and replace simultaneously. Other congressional leaders, including Rep. Greg Walden, are even using the term “repair” now. We have yet to see the GOP align around any proposed replacement plan. In addition, Republicans will need some Democrat support to pass replacement legislation.

While the executive order does not immediately enforce tangible changes, it does raise questions for employers as to how to move forward. Based on our view into Washington, we continue to believe major reform is unlikely to happen quickly. Health e(fx) recommends employers:

  1. Carry on and submit 2016 reporting (if not already submitted)
  2. Continue to comply with the ACA, including eligibility/affordability mandates and reporting requirements
  3. Watch for updates from Health e(fx) on any regulatory changes

We continue to closely watch activity on the Hill and were recently quoted in the local Star Tribune on the impact of repealing or replacing the ACA on large employer groups. We will continue to advocate for our clients and provide updates on ACA activity.