Obamacare Debate

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Secretary Price Hosts Listening Session with Obamacare Victims


WASHINGTON DC -- On Wednesday, Health & Human Services Secretary Tom Price, M.D., hosted a listening session at the White House with Administrator of the Centers for Medicare and Medicaid Services Seema Verma to hear from individuals who are facing a lack of choice in healthcare plans due to insurers pulling out of Obamacare marketplaces.

Citizens from Ohio, Iowa, and Missouri shared real-life stories of how Obamacare has negatively impacted themselves, their families, their businesses, and their communities. These real-life examples show the extremely limited options of healthcare plans that are available, and the consequences of such high premiums and deductibles.

A small business owner from Missouri spoke of his inability to keep employees because of the advantage Obamacare gives to large corporations. An insurance agent from Missouri spoke of her guilt as she was unable to help her friends and neighbors, and was forced to deny them insurance due to the high costs. A doctor from Iowa spoke of his children, both diagnosed with a terminal disease, and his struggle as he was forced to choose between his practice and his children’s medical care.

These examples, among countless others, demonstrate the tolls Obamacare has taken on the American people. The American people are frustrated with Obamacare, and they are looking for change. Secretary Price reaffirmed the Administration’s commitment to reduce Obamacare’s burdens by providing the American people with the highest quality healthcare system.

Americans are Suffering Under Obamacare, Hear Their Stories


WASHINGTON DC -- On Monday, President Donald J. Trump held a listening session at the White House to hear directly from Americans that have experienced significant hardship as a result of Obamacare’s poor coverage and rising prices.

President Trump wants to hear from you, too. Share your Obamacare disaster story with the President here

The individuals in attendance included: 

Ms. Kim Sertich of Arizona, whose health insurance has been cancelled three times since Obamacare became law. The plans now available to her have limited networks and high deductibles. Even worse, she will only have one insurer to choose from in 2017. 

Mrs. Carrie Couey of Colorado, a mother of six from a cattle ranching family whose youngest son is autistic. The pre-Obamacare cost for her family’s insurance was $17,000 per year. After Obamacare became law, her insurance costs skyrocketed to $52,500 per year for a lower quality plan. Additionally, the cost for workers’ compensation insurance for her business’s employees increased from approximately $17,000 per year to more than $70,000 per year. 

Mr. Elias Seife of Florida, who has had to change his and his wife’s health insurance every year for the past few years because his premiums have increased 30-40 percent annually, and the deductibles are even worse than the premiums. Mr. Seife said that the middle class has been particularly hard-hit by Obamacare.  

Ms. Brittany Ivey of Georgia, a working mother whose family has struggled under Obamacare. Ms. Ivey was working part-time at a small business that provided her family with health insurance until Obamacare raised her premiums sharply. This drove the Ivey family into the individual market, where a mid-level plan cost 65 percent of her monthly gross income, even accounting for a federal subsidy. 

Mr. Greg Knox of Ohio, the owner of Knox Machinery and Chairman of the Dayton Region Manufacturers Association, which have both been significantly affected by Obamacare’s rising prices. Mr. Knox expressed optimism that President Trump will return free market principles to our Nation’s health care system, which will benefit consumers by increasing options and lowering costs. 

Mr. Joel Brown of Tennessee, a farmer whose costs for catastrophic coverage has spiked in the wake of Obamacare, from $119 per month to more than $500 per month. As a result, Mr. Brown was forced to settle for a much less desirable plan provided through his church, which cost him $280 per month. 

Dr. Manny Sethi of Tennessee, founder of Healthy Tennessee, a non-profit organization designed to promote preventative healthcare and has seen first-hand Obamacare’s negative effects on the medical profession. As an orthopedic trauma surgeon and Assistant Professor at Vanderbilt University, Dr. Sethi is well aware of how Obamacare has harmed patient care across the country.  

Dr. Robin Armstrong of Texas, a medical doctor whose wife is a breast cancer survivor. Dr. Armstrong strongly opposes Obamacare because its rising premiums and deductibles have hurt his patients. Dr. Armstrong told the President he is excited about the reforms in the American Health Care Act and believes they will drastically improve the system. 

Hon. Stan Summers of Utah, a local county commissioner whose family has endured significant hardship as a result of Obamacare. Mr. Summers’ wife has been very sick and his son has struggled with a rare disease. Their insurance costs have skyrocketed as a result of Obamacare. 

Mr. Louis Brown of Virginia, a 35-year-old attorney who currently works for the Christ Medicus Foundation, a Catholic healthcare foundation. In 2009, as Obamacare was moving through Congress, Mr. Brown was a staffer at the Democratic National Committee. He told President Trump that after much prayer and soul searching, he resigned from the DNC because he could not support a party that wanted to include taxpayer funding of abortion in Obamacare. Today, Mr. Brown supports the reforms in the American Health Care Act. 

Ms. Gina Sell of Wisconsin, a young nurse who has had to work much longer hours to afford her increased health insurance premiums under Obamacare. In fact, her premiums now cost her more than her mortgage. 

After hearing these stories, President Trump, Vice President Mike Pence, and Secretary of Health and Human Services Tom Price each committed to fighting for reforms that will bring costs down and increase access to care for all Americans. 


Obamacare is Failing Americans


WASHINGTON DC -- Today, families from across the country joined me at the White House to share their healthcare journeys and discuss the urgent need to repeal and replace Obamacare. Their stories aren’t unlike the lives of so many Americans suffering under this failed law.

Stories like Christine Chalkey and her son Jacob, who has a very rare condition and receives treatment through Medicaid in Illinois. The state’s expansion of Medicaid under Obamacare means that the people who need care the most – like Jacob – have seen shrinking services. Christine called Obamacare’s impact “an injustice happening to the truly most vulnerable.”

David Moody, from Nevada, is a retired police officer who couldn’t afford an expensive Obamacare plan for both him and his wife, so he went uninsured so his wife could have the care she needs. He shared simply, “I have no healthcare because I just can't afford it.”

And Amy and Robert Dean, foster parents from Texas with six children, have been forced to change doctors every year under Obamacare – a hardship especially for their child with a chronic liver disease. At the White House today, Robert urged “America can and should do better. Our Congress needs to listen to these people and how it’s real Americans that this is affecting.”As I’ve traveled across America, I’ve heard countless stories like these that show Obamacare is an unbearable burden for American families. This failed law is harming the very people it was supposed to help – including children and the most vulnerable in our society.

The average Obamacare premium has more than doubled in the past four years – and in some states, premiums have more than tripled.While premiums are soaring, choices are plummeting. A third of American counties, including five whole states, only have one choice of Obamacare coverage – no choice at all. And insurers continue to abandon Obamacare. Virtually every day there’s news of another major insurance company leaving the Obamacare exchange in another state around the country.

But the story of Obamacare’s failure is not a story of statistics. It’s the story of real people and the real hardship placed on the American family. The truth is that Obamacare has failed – and Obamacare must go.

At this very moment, the United States Senate is working on a bill to give us an opportunity to turn the page on the failed policies of Obamacare. This measure builds on the progress made by the House earlier this year.

We’re grateful to Leader Mitch McConnell, Speaker Paul Ryan, and Republicans in Congress for their work.

President Trump and I strongly support this bill. Our administration is working with the Senate around the clock to get it passed. This is the moment – now is the time. Working with Congress, President Trump will keep our promise to rescue the American people from the nightmare of Obamacare.

As the families who gathered at the White House can attest, like so many Americans across this country, America can’t afford Obamacare any longer. And President Donald Trump will keep fighting every day to give the American people the world-class healthcare they deserve. 


Americans’ Health Insurance Options Are Disappearing At a Startling Rate


WASHINGTON DC -- Under Obamacare, Americans’ health insurance options are disappearing at a startling rate. Illustrating just how dire the situation really is, the Administration recently updated a county-level projection of health insurance exchange participation for 2018. The map shows that plan options will continue to decline and, in some areas, Americans will be left with no health insurance options on the Obamacare exchanges.

The map below (https://www.whitehouse.gov/blog/2017/06/20/americans-health-insurance-options-are-disappearing-startling-rate) shows that forty counties nationwide are currently projected to have no insurers, meaning that Americans in these counties could be without coverage from the exchanges next year. In more than 1,300 counties - over 40% of counties nationwide - Americans could be left with only one option and no choice of health insurance provider under Obamacare. 

Currently, at least 27,000 active exchange participants live in the counties projected to be without coverage in 2018, and roughly 2.4 million participants are projected to have only one issuer. It’s clear that Obamacare is an inefficient and unsustainable way to provide health insurance to the American people.


Obamacare is Failing the American People


WASHINGTON DC -- The previous Administration sold Obamacare to the American people through a series of empty promises. Premiums were supposed to drop, but instead they have soared by nearly $3,000. Choices were supposed to multiply, but instead they disappeared, leaving one third of American counties with only one insurer in 2017. The public was supposed to learn to love Obamacare, but 6.5 million Americans chose to pay $3 billion in penalties to the IRS instead of buying health insurance in 2015.

These are the facts about Obamacare, and no one understands them better than Vice President Mike Pence. As a Congressman, he watched the Obama Administration make untenable claims about the future benefits of Obamacare. As the Governor of Indiana, he saw the failure of Obamacare unleashed on state insurance markets across the country. And as a man of integrity and compassion, he understands that the real tragedy of Obamacare is found in the personal stories of millions of hardworking Americans who have been locked out of the healthcare system, and are unable to access the care they need.

In a recent speech to the Department of Health and Human Services, Vice President Pence told the story of one of those Americans—Julie Champine from Milwaukee, Wisconsin—and reaffirmed our Administration’s continued commitment to repealing and replacing Obamacare. You can hear Julie’s story and learn more facts about the collapse of Obamacare in the video above (https://www.whitehouse.gov/blog/2017/06/20/obamacare-failing-american-people).


Sec. Perry: “Time to discard the burdens and costs of Obamacare”

The White House
Office of the Press Secretary
For Immediate Release
July 25, 2017

By Rick Perry, U.S. Secretary of Energy

JULY 25, 2017 --  WASHINGTON DC -- On Jan. 25, 2007, then-Sen. Barack Obama delivered a speech declaring that "the time has come for universal health care in America." Two years later, he was president of the United States -- and he told a joint session of Congress that health care was his top priority. Just over a year after that, Obamacare became the law of the land.

America has been staggering under its burdens and failures ever since.Insurance companies have pulled up stakes in states across the country, leaving consumers few options throughout the country.

Costs have risen dramatically, despite Democratic promises Obamacare would lower insurance costs. Patients have lost choices, doctors and insurance plans, and in some cases, lost access to cancer specialists and other life-saving caregivers.

It was always predictable Obamacare would collapse of its own weight because it centralizes health care in America, empowering the bureaucracy instead of doctors and patients. It has not controlled health care costs as promised. Instead, Americans are paying more than ever. Unchecked, it is careening toward disaster.

The answer to this massive problem is not to do nothing. That would expose millions of Americans to greater risk because of a paralysis to act. It is to pass patient-centered reform that expands choices while mending the safety net the most vulnerable Americans rely upon for their care.

Lost in the reform debate is a mention of the best solution. The best antidote to the failures of centralization is decentralization.

It's time to empower the states, as our federalist system envisions.

I served as governor of Texas, the second largest state, for 14 years. I know full well that Texans largely have different ideas about health care than well-intentioned Washington bureaucrats.

Over the years, Texas has done a number of innovative things to improve health care in ways we knew made sense for Texas.

The Lone Star State set up its own high-risk pool to help people with pre-existing conditions; it established programs like Special Needs for Children, Star+Plus, which is our state-managed home and community-based services program, and PACE, Texas' all-inclusive program for elder care.Washington would not have known how to do those things right for Texas.

For an issue as personal and as important as health care, there's no one policy Congress can come up with that will be right for some 320 million Americans. It's why, when Obamacare was implemented in 2014, hundreds of thousands of Texans decided they'd rather pay fines than navigate the Byzantine system of regulation, and its various unintended costs.

The proposal from Congress contains many positive reforms to Medicaid -- in fact, they are included in the Senate's Better Care Reconciliation Act. These would give states more control to deliver better care at lower costs for those in need.

The spirit of those reforms should be incorporated into the rest of the health care debate to free states fully from the regulatory burdens of Obamacare that Washington has imposed upon them.

Greater flexibility alone will not solve the problem for states caring for the sick and poor. Sufficient federal resources are still needed for governors to deliver effective care under Medicaid. I agree with Sens. Ted Cruz of Texas and Mike Lee of Utah that health care choices should be transparent and free of Washington requirements. Let's keep the costs of plans down for everyone and make sure Americans with pre-existing conditions are adequately covered.

There is an historic opportunity for Congress to finally empower people and states and move control out of Washington. There will not be another opportunity like this for a very long time.

It has never been enough to repeal Obamacare. Repeal is obvious, because its failure is obvious. Replacing it is much harder work. But it must be done, with a focus on returning health care to states, individuals, and the health care professionals that care for them.

The debate over health care has consumed Washington for over a decade. America can't afford another decade of spiraling costs, political bickering, or inaction.

This may be the only window we have to do this. Millions of Americans are depending on their representatives to repeal this crushing law and can benefit from the common-sense solutions being considered in the Senate.

We cannot, and must not, fail them any longer.


Obamacare Failures in the News


“Forty-seven counties are projected to have no Obamacare insurers next year and 1,200 could have only one, according to a new federal report.”

-Washington Examiner


“The state of Delaware has only two insurers participating on the exchanges this year…”

-Washington Free Beacon



“One of the last insurers on Iowa's ObamaCare exchanges announced … an average rate increase of 43.5 percent.”

-The Hill


“CareFirst asked the Maryland Insurance Administration for average premium increases of 52 percent in 2018”

-The Baltimore Sun


“…the nation’s second-largest health insurer announced Wednesday it plans to pull out of ObamaCare exchanges in Indiana and Wisconsin…”

-Fox News


“New York’s health insurers will request double-digit rate increases for ObamaCare policies for 2018”

-New York Post

key words: Obamacare, skyrocketing premiums, health insurance cancellations; 116% increase in health insurance premiums in Arizona; Obamacare premiums, health insurance rate increases.

The fundamental error in the CBO’s health-care projections

By Marc Short and Brian Blase 

July 14 2017

Marc Short is assistant to the president for White House legislative affairs. Brian Blase is special assistant to the president for the National Economic Council.

In the coming days, the Congressional Budget Office will release an updated analysis of the Senate bill to repeal and replace Obamacare. The CBO will likely predict lower health insurance coverage rates if the bill becomes law. The American people and Congress should give this prediction little weight in assessing the bill’s merit.

The reason: The CBO’s methodology, which favors mandates over choice and competition, is fundamentally flawed. As a result, its past predictions regarding health-care legislation have not borne much resemblance to reality. Its prediction about the Senate bill is unlikely to fare much better. When Obamacare passed in 2010, the CBO projected a healthy individual market with 23 million people enrolled in exchange plans by this year. The CBO predicted that by 2017, exchange plans would be profitable and annual premium increases low.

The CBO reached these conclusions, in large part, because its model puts significant weight on the individual mandate. The CBO expected millions of relatively young and healthy people to buy exchange plans under government coercion.

But this never happened. Today, there are only 10 million people enrolled in exchange plans — about 60 percent fewer than expected. (Contrary to some claims, this is not because more people have maintained employer plans than the CBO expected; the reduction in employer coverage has been greater than the CBO projected, and overall about 9 million more people are uninsured now than projected.) Absent the projected bounty of young, healthy consumers, health insurers are abandoning the exchanges, leaving a third of American counties with only one insurer to choose from. As insurers continue to flee the exchanges, consumers will face even fewer options next year.

And while choice is declining, costs are skyrocketing. A recent analysis by the Department of Health and Human Services found that the average annual premium on the individual market has more than doubled since 2013 — up nearly $3,000 in only four years. Premiums seem set to increase at least 25 percent next year as well. These hikes, along with the large drop in insurer participation, show that many state exchanges are descending deeper into adverse-selection spirals.

The CBO failed to foresee any of this. Despite the obvious shortcomings of its previous analyses, the CBO has utterly failed to update its model to account for reality. Instead, the CBO continues to attribute mythical power to the individual mandate.

Two examples clearly show the flaws. First, the CBO believes that about 15 million people value their insurance so little that they will simply drop coverage next year following the repeal of the individual and employer mandates — an unlikely occurrence given the individual mandate’s inability to cause people to enroll thus far. 

Furthermore, this figure includes approximately 4 million people on Medicaid, even though Medicaid enrollees pay little or nothing for coverage and are largely exempt from the penalty. It makes little sense for fewer individuals to have Medicaid coverage just from the repeal of the individual mandate, yet the CBO predicts millions of fewer Medicaid enrollees.

Second, the CBO estimates that the Obamacare exchanges will average 18 million enrollees next year assuming the law remains in place. Yet only about 10 million Americans had exchange plans in 2015, 2016 and 2017 — and the CBO ignores Obamacare’s collapse. Simply put, the CBO predicts coverage under Obamacare that will never materialize. 

The CBO’s belief in the power of the individual mandate skews its premium estimates as well. If the mandate actually compelled millions of additional healthy and young people into the market, as the CBO assumes, lower average premiums would result. 

But such consumers have largely steered clear of the law. By failing to account for this reality, the CBO’s estimate of any replacement measure assumes that consumers will leave a market they never joined in the first place — and correspondingly estimates higher premiums than will materialize.

Beyond the individual market, the CBO has also failed to properly analyze Obamacare’s Medicaid expansion. For one, the Medicaid expansion to working-age, non-disabled adults has proved to be substantially more expensive than the CBO projected — nearly 50 percent more expensive per enrollee. The forthcoming analysis of the Senate bill will likely contain additional projection errors. It will almost certainly assume that many additional states would expand Medicaid under Obamacare, even though other agencies, such as the Office of the Actuary at the Centers for Medicare and Medicaid Services, have determined this is highly unlikely

An assumption that states will expand Medicaid means that the CBO will determine that millions of people will “lose” Medicaid coverage under the Senate bill — but these people were never enrolled in the first place.

The American people — and their representatives in Washington — deserve the most accurate assessment possible of the effects of critical health-care legislation. Although the CBO generally plays a valuable role in the legislative process, as Obamacare’s ongoing failure clearly demonstrates, the CBO’s health-care model is fundamentally flawed. The CBO’s failure to update the model means its forthcoming analysis of the Senate bill will be no better — and perhaps worse — than its disproven Obamacare projections. Although the media and the political left will certainly seize on it, the CBO’s estimates will be little more than fake news.


White House Statement on Today’s Announcement from CMS on Declining Obamacare Insurance Market

The White House
Office of the Press Secretary

For Immediate Release

JULY 10, 2017 -- WASHINGTON DC -- Today’s announcement shows that insurers continue to flee Obamacare at an alarming rate. With only half the number of issuers wanting to sell Americans plans on Obamacare’s exchanges today than just two years ago, it is now more clear than ever that Obamacare’s collapse is accelerating and that the American people need real reform.

With costs out of control and choices continuing to dwindle, now is the time for Congress to act.



HHS Secretary Price: “ObamaCare’s Victims Need Relief Now”

The White House
Office of the Press Secretary
For Immediate Release
June 28, 2017

ObamaCare’s Victims Need Relief Now
By Tom Price, MD
Wall Street Journal 

JUNE 28, 2017 -- WASHINGTON DC -- America faces an urgent crisis in its health-care system. Costs are skyrocketing and choices are disappearing on the individual and small-group markets. Many people now confront the real challenge of having no choice in their health coverage.

One of them is Doug Lake, an Iowa radiologist who came to the White House last week to share his story. His daughter, who suffers from a rare cardiac condition, is covered by an insurer that plans to pull out of ObamaCare’s exchange in their state next year. Only one insurer remains in their county, and that company has requested a 43% increase in premiums.

The situation is even worse elsewhere. As of this week, 49 counties across the country do not have a single insurer offering plans on the exchanges next year.This year more than 1,000 counties had only one insurer in the ObamaCare market, meaning millions of Americans had no meaningful choice. Meanwhile, the insurers that did stay in the market increased premiums for their midlevel plans by an average of 25%. Premiums on the individual market are up about $3,000 since ObamaCare was implemented. Think about what else that money could buy!…

Under ObamaCare, insurers are either running for the exit doors or proposing huge premium increases. Americans instead deserve a market where companies clamor to offer competitive plans to as many customers as they can. 

That is what Congress has the chance to make possible, and it can’t come a day too soon.


White House Statement on CBO Healthcare Report

The White House
Office of the Press Secretary
For Immediate Release

JUNE 26, 2017 -- Washington DC -- The CBO has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage. 

This history of inaccuracy, as demonstrated by its flawed report on coverage, premiums, and predicted deficit arising out of Obamacare, reminds us that its analysis must not be trusted blindly.  In 2013, the CBO estimated that 24 million people would have coverage under Obamacare by 2016.

It was off by an astounding 13 million people – more than half—as less than 11 million were actually covered.  Then, CBO estimated that 30 million fewer people would be uninsured in 2016, but then it had to reduce its estimate to 22 million, further illustrating its inability to present reliable healthcare predictions. We know the facts.

To date, we have seen average individual market premiums more than double and insurers across the country opting out of healthcare exchanges.  As more and more people continue to lose coverage and face fewer healthcare choices, President Trump is committed to repealing and replacing Obamacare, which has failed the American people for far too long.


Adversely Affected Families

President Trump Meets With Families Adversely Affected by Obamacare


JULY 24 2017 -- WASHINGTON DC -- On Monday, President Donald J. Trump welcomed four families adversely affected by Obamacare to the White House for a listening session. These victims of Obamacare shared stories of skyrocketing premiums, denied access, restrictions, and low reimbursement rates due to Obamacare’s failing infrastructure.

Among the group visiting the White House was the Ackison family from Marysville, Ohio. Melissa Ackinson was denied coverage after her eight-week old child was mistakenly omitted from their insurance plan. Melissa was concerned by the lack of coverage for her infant as her other son had recently returned from hospitalization due to an unnamed infectious disease. While Melissa had the opportunity to pay for the immunizations out-of-pocket, she could not afford the high cost of premiums and even higher deductibles on her marketplace plan.

The Finn family from Morgantown, West Virginia, decided to try Obamacare to cover employees in their family business, but suffered the effects of a 200% rate increase on deductibles after the first year, leaving them unable to provide healthcare coverage to those working for the company.

Members of the Weer family from Mount Pleasant, South Carolina voiced concerns over the stability of the current healthcare system. Their three-year-old son Monty was diagnosed with Spina Bifida. Since his birth, he has been with two different insurance companies and healthcare plans which has made continuity difficult. Because Blue Cross Blue Shield is the only insurance company available in their area, the family is continually negotiating with clinics or traveling outside of the state.

The Witzig family from Washington, Illinois, also attended the listening session. Erin and Andy Witzig own a small business, and desire to have the best coverage possible for their six children. Their youngest daughter Poppy has a rare genetic condition, Recessive Dystrophic Epidermolysis Bullosa (RDEB). This requires her to be in bandages from neck-to-toe every day. These specialty bandages are used by burn victims and are extremely costly. Every year since the implementation of Obamacare, their private insurance plan for Poppy has been discontinued and replaced with a new, supposedly equivalent, policy that is always more expensive and has far less benefits.

President Trump and Vice President Pence met with the healthcare victims and their families, ensuring that the Administration was committed to repealing and replacing Obamacare. The President then gave remarks, reaffirming his mission to find a healthcare solution that will better serve the American people.

“To every member of the Senate, I say this: The American people have waited long enough. There’s been enough talk and no action. Now is the time for action. We are here to solve problems for the people. Obamacare has broken our healthcare system -- it’s broken, it’s collapsing, it’s gone. And now it is up to us to get great healthcare for the American people. We must repeal and replace Obamacare now,” President Trump stated.


Executive Order Minimizing the Economic Burden of the ACA Act

The White House
Office of the Press Secretary
For Immediate Release

JANUARY 20, 2017 

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


- - - - - - -


By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1.  It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act (Public Law 111-148), as amended (the "Act").  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 the 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 healthcare market.

Sec. 2.  To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

Sec. 3.  To the maximum extent permitted by law, the Secretary and the heads of all other executive departments and agencies with authorities and responsibilities under the Act, shall exercise all authority and discretion available to them to provide greater flexibility to States and cooperate with them in implementing healthcare programs.

Sec. 4.  To the maximum extent permitted by law, the head of each department or agency with responsibilities relating to healthcare or health insurance shall encourage the development of a free and open market in interstate commerce for the offering of healthcare services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.

Sec. 5.  To the extent that carrying out the directives in this order would require revision of regulations issued through notice-and-comment rulemaking, the heads of agencies shall comply with the Administrative Procedure Act and other applicable statutes in considering or promulgating such regulatory revisions.

Sec. 6.  (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.


January 20, 2017