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What Does Trump's Affordable Care Act Executive Order Do?


We're going to take a break from covering the women's marches today to talk about one of President Donald Trump's first moves after taking the oath of office yesterday. President Trump signed an executive order to limit what he calls the quote, unquote, "burdens of the Affordable Care Act," taking a step toward fulfilling his campaign promise to dismantle the law. NPR health policy correspondent Alison Kodjak is with us now to explain exactly what Donald Trump's order does and what it cannot do. Alison, thanks so much for joining us.

ALISON KODJAK, BYLINE: Thanks for having me.

MARTIN: So what exactly is in this executive order? What is the president trying to do here?

KODJAK: Well, the order talks broadly about, quote, "easing the burden of the Affordable Care Act." But he talks about easing the burden, not just on individuals, but on insurance companies, on hospitals, on doctors, on medical device-makers, pretty much across the board, saying this law is hurting the entire health care industry.

And what it does is essentially sets the direction of policy for it. It tells all the heads of all his agencies, who haven't yet been confirmed mostly, that they should find ways to ease the financial burden of this law on all these constituencies.

MARTIN: Now, that's a pretty sweeping mandate. What can the order specifically require them to do at this point?

KODJAK: Well, it's a little bit vague because it depends on how aggressive they want to be. He specifically mentions the Department of Health and Human Services. He's nominated Representative Tom Price, who probably will be confirmed sometime in the next days or weeks. The HHS has a lot of regulations, such as the minimum requirements for coverage that they could change through a rule-making process. In addition, the HHS has the power to offer waivers to people who say that the individual mandate to buy insurance is a hardship.

So there are some people who speculate, oh, they're going to just start giving waivers to anybody who complains. They can't not enforce the law, meaning they have to have the IRS actually collect the penalty if people don't buy insurance. But if they offer too many of these waivers, that could kind of undermine the individual market by making people not buy insurance.

MARTIN: But is the danger here that the individual market could actually collapse before there is a replacement for it? Because that's what leads me to - my final question to you is how does this dovetail with President Trump's other plans and promises?

KODJAK: If they want to have a replacement before they repeal the law, then they clearly don't want the market to collapse, you know, in some sort of chaotic way. At which point, it's probably unlikely that they'll be too aggressive. It sort of just sets the tone of this is our intention, this is what we want to do. However, if they do want to really push it hard, they could do some damage early on.

MARTIN: So Alison, what is the bottom line here?

KODJAK: Well, no one's quite sure because President Trump and his colleagues on Capitol Hill don't yet seem to be on the same page about what they want. He has said he wants insurance for all. They've said they want to provide an atmosphere where everybody has access to insurance. And so we need to see where they're going to go with that.

MARTIN: That's NPR health policy correspondent Alison Kodjak here in our studios in Washington, D.C. Alison, thank you so much.

KODJAK: Thanks, Michel. Transcript provided by NPR, Copyright NPR.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.
Michel Martin is the weekend host of All Things Considered, where she draws on her deep reporting and interviewing experience to dig in to the week's news. Outside the studio, she has also hosted "Michel Martin: Going There," an ambitious live event series in collaboration with Member Stations.