President Donald Trump has signaled he may institute new health care policies through an executive order. The potential directive is reportedly influenced by Republican Sen. Rand Paul of Kentucky and would allow health insurers to sell their policies in other states and for groups of people to pool together as a health association. Critics contend these measures could adversely impact people with pre-existing conditions.
On Sept. 27, Trump stated during a press conference that he was considering an executive order that would institute new health care policies.
"I'll probably be signing a very major executive order where people can go out, cross state lines, do lots of things and buy their own health care, and that will be probably signed next week," Trump said.
The president added: "It's being finished now. It's going to cover a lot of territory and a lot of people. Millions of people."
Trump's announcement followed another unsuccessful attempt by GOP lawmakers to repeal and replace the Affordable Care Act. On Sept. 26, Republican Senate Majority Leader Sen. Mitch McConnell of Kentucky announced he would not hold a vote on Graham-Cassidy, a health proposal that was considered the Senate Republicans' last chance to repeal the ACA in 2017.
"We haven't given up on changing the American health care system," McConnell said, reports The New York Times. "We are not going to be able to do that this week, but it still lies ahead of us, and we haven't given up on that."
The pending executive order would likely implement two health care proposals previously made by Paul: allowing insurers to sell policies across state lines and allowing for professional associations to band together to buy health coverage as a group.
Shortly after Trump's announcement, Paul asserted during an interview that his proposals would stimulate competition in insurance markets.
"I believe President Trump can legalize on his own the ability of individuals to join a group or a health association across state lines to buy insurance," Paul told MSNBC. "This would bring enormous leverage to bringing down prices. It would also bring protection to individuals who feel left out, hung out to dry, basically."
Paul's proposal would allow for insurers to sell policies from their original state to patients in other states. While advocates of the policy assert that it would spur competition and lower premiums, critics believe it would also lead to skyrocketing costs for patients with pre-existing conditions.
Some states regulate higher minimum benefits than others. If an insurance from a state that allowed for minimal plans was able to sell its policies to a state that mandated more comprehensive coverage, healthier patients would potentially sign on in droves and leave the state markets with a higher ratio of sick people, creating higher prices, according to CNN Money.
Meanwhile, Paul's other proposal would allow for groups of people to form their own health associations to buy group health insurance. The Kentucky senator asserted his idea was a "free market reform that will cost the federal government nothing, but has the possibility of allowing millions of people to get inexpensive insurance."
Critics of this idea believe it would also hurt patients with pre-existing conditions. If groups of healthy people could form associations and buy policies from other states, sicker patients would make up a higher ratio in markets for states that mandate more comprehensive coverage.
Health care providers said they would need to know more details of Trump's executive order before they could take a stance on the potential policies.
"It's really hard to say much definitive without knowing the specifics of what the president may be doing," Larry Levitt of the Kaiser Family Foundation told BuzzFeed News.
The National Association of Insurance Commissioners CEO Mike Consedine said he would also need to know more about the proposal but noted that his group believed that allowing associations to sell policies across states would be redundant.
"As a general matter, health insurers already have the ability to sell insurance in multiple states as long as they comply with state consumer protection and licensing laws, which many already do," Consedine said. "The NAIC has long been opposed to any attempt to reduce or preempt state authority or weaken consumer protections."