“Repeal and Replace” Gives States More Control over Healthcare Market
The Trump administration has made it clear that the Affordable Care Act is on the chopping block with its “repeal and replace” agenda. While a specific replacement has not yet been identified, an executive order signed on Friday implores federal agencies to act within the constraints of the ACA to delay or even waive portions of the law that they believe place too high a cost burden on insurers, providers, consumers, and states. The order says:
In the meantime, pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize unwarranted economic and regulatory burdens of the act, and prepare to afford the states more flexibility and control to create a more free and open health care market.
While the order does not specify aspects of the law to focus on, it clearly states that the goal of any ACA replacement will be to give states more control over government-funded health care options (particularly Medicaid) while simultaneously weakening state control over private health insurance by promoting the sale of policies across state lines. The U.S. does have some version of this in place right now, since states determine their own patient eligibility criteria for Medicaid...