Executive Order 13765: Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

President Trump constantly stated his intent to repeal the Affordable Care Act (the ACA, or “Obamacare”), even since before he announced his candidacy in 2015. It’s fitting, then, that his first executive order asked executive department heads to do whatever they could within the bounds of the law to, from his perspective, ameliorate the burdens of the ACA. Specifically, this Order asks department heads to use their full authority to prevent any financial burden caused by the ACA from taking effect, and to attempt to create deregulated markets for healthcare that give states more agency.

This Executive Order establishes a general Trump administration strategy against Obama administration attempts to use the government to improve the American healthcare system. For instance, the ACA created a government-run “Health Insurance Marketplace”, where private insurance companies could pitch heavily regulated plans. The ACA was seen by many as a success, since the number of uninsured Americans lowered heavily after it passed, but many still oppose it on ideological grounds and point to major implementation failures as evidence that government-run healthcare can’t work. The Trump administration has opted to stand in the way of the program, and this Order establishes an executive branch-wide policy effort. For example, the Center for Medicare and Medicaid Services halved the length of time each year during which people can find and join a healthcare program in the Marketplace. The Department of Health and Human Services cut the ACA advertising budget from $100 million to $10 million and cut funding for non-governmental organizations which help people sign up for ACA-provided healthcare plans. The administration even stopped paying insurers to discount ACA plans for Americans with incomes close to the federal poverty line. Over the Trump administration, the stated benefit of Obamacare, lowering the number of uninsured Americans, was turned back a bit, and 2.3 million more Americans were uninsured in 2019 than 2016, to say nothing of the millions who lost their healthcare coverage during the COVID-19 pandemic.

It is extremely likely that this Executive Order will be immediately repealed during a Democratic administration, since the Democrats generally want the ACA to work as intended, and the ACA has not been repealed.