On Wednesday, the Trump Administration submitted a proposed rule to the Office of Management and Budget designed to help stabilize the ACA marketplaces. Details on the rule are not currently available as it has not yet been published, but it is expected to address a number of immediate fixes to stabilize the marketplaces in the coming year. The administration is also in the process of releasing an executive order directing the Department of Labor to review the fiduciary rule, which currently imposes significant requirements on health savings accounts. NAHU will continue to monitor these regulatory items and will update members as details become available. The proposed rule on stabilizing the marketplace is the first regulation directed at the department of Health and Human Services since President Trump took office two weeks ago.
NAHU has called on the Trump Administration, and previously the Obama Administration, to implement several changes that would improve stability in the individual marketplaces. We have suggested that the administration could restrict the use of special enrollment periods (SEPs) to reduce their abuse and also implement more stringent documentation requirements. Similarly, we have called on reducing the current 90-day grace period for individuals with premium tax credits down to 30 days for non-payment. We also suggest allowing “grandmothered” policies to continue beyond their 2017 expiration date and removing limitations on “grandfathered” policies. And we have called on the administration to simplify the employer reporting requirements. NAHU CEO Janet Trautwein’s testimony before the Senate Health, Education, Labor and Pensions Committee included many of these suggestions.
The proposed rule follows an executive order (EO) issued by President Trump on Monday, which requires that for every new regulation that is issued, two previous regulations must be eliminated. Based on interim guidance released today and a previous executive order from 1993 that is still in effect, the rule will apply to any “significant” regulation that imposes an annual economic cost of $100 million or more. Agencies issuing regulations starting on September 30 will need to identify two existing regulations to eliminate prior to the new regulation being issued, as well as fully offset total incremental cost of the new regulation. Regulations addressing health, safety or financial emergencies may request a waiver from this requirement. This EO order fulfills a campaign pledge that was part of President Trump’s 100-day plan, and follows a listening session last Monday with a dozen business executives from several large companies where he promised to cut regulations by 75%. President Trump has issued seven executive orders and 11 presidential memorandums since taking office on January 20.
NAHU is continuing to work with the Trump Administration and congressional leadership to determine the best approach and timing for change in our healthcare system. We will continue to update you as any other regulatory changes, EOs or legislation are released. In the meantime, all statutes and regulations enacted by the ACA continue to be in place and NAHU members should continue to work with their clients to be in compliance with the law. Additionally, if you have suggestions regarding our work with the Trump Administration and members of Congress on the future plans to reform the ACA that you would like to share with NAHU, you can send your thoughts and ideas to ACAreform@nahu.org.