After attempts to repeal the Obama administration's signature healthcare law faltered, the Trump administration set an agenda for the Affordable Care Act's implementation next year.
In signing a major tax reform bill into law late last year, President Donald Trump claimed to have "essentially repealed Obamacare" by neutralizing the legislation's individual mandate penalty.
But the Affordable Care Act (ACA) is still on the books—and gaining in popularity—despite the repeal-and-replace rhetoric Trump and fellow Republicans have voiced for years.
The administration acknowledged that fact on Monday when it unveiled a final rule for ACA implementation in 2019.
“Too many Americans are facing skyrocketing premiums that they can’t afford and every year consumers are faced with the threat of fewer choices," Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said in a statement blaming the ACA for rising insurance premiums and declining choices. "This rule gives states new tools to stabilize their health insurance markets and empower citizens to find coverage that fits their families’ needs and budgets."
A draft version of the final rule, which is scheduled for publication in the Federal Register on April 17, is available online.
"Over time, issuer exits and increasing insurance premiums have threatened the stability of the individual and small group Exchanges in many geographic areas," the proposal's executive summary states, adding that the final rule will focus on enhancing the role states play in ACA programs, increasing flexibility, "reducing unnecessary regulatory burden on stakeholders, empowering consumers, and improving affordability."
Verma's summary of the final rule notes that this increase in flexibility will give states more leeway in defining essential health benefit (EHB) benchmarks.
The push for added flexibility comes as the administration has sought also to ease restrictions on short-term, limited-duration insurance and association health plans, which are exempt from some of the ACA’s requirements.
Andy Slavitt, who served under former President Barack Obama as CMS administrator, said in a tweet that the rule lowers protections for people with preexisting conditions, increases the cost of coverage, and increases barriers to enrollment.
"It’s an effort to create a very different vision that looks like 2007," he added.
Steven Porter is editor at HealthLeaders.