Immediately upon entering office, President Trump signed an Executive Order on January 20th entitled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” stating his commitment to repealing the Affordable Care Act (ACA) and directing administration officials to avail themselves of existing authority to provide flexibility in administration of the ACA. While the Executive Order provided no new authority and made no policy changes itself, it did provide examples of flexibility that should be exercised. Specifically, federal agencies were directed to:
- Exercise existing authority and discretion to “waive defer, grant exemptions from, or delay implementation” of provisions of the ACA that are considered burdensome, which could include making changes to the Essential Health Benefits and providing greater flexibility in granting hardship waivers from the individual coverage mandate;
- Provide greater flexibility to states, which could include regarding Section 1332 State Innovation Waivers and Section 1115 Medicaid Demonstration Waivers; and
- Encourage development of a free and open market in interstate commerce.
The Executive Order does specify that regulatory changes must comply with the Administrative Procedure Act (though interim final rulemaking and guidance can be issued without public notice or hearings).
Shortly thereafter, on January 30th, the President also issued an Executive Order requiring that federal agencies identify two existing regulations to be repealed for any new regulation they propose.