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Trump Readies Major Change in Health Care Without Congress

President Donald Trump said on Tuesday to expect an executive order on health care soon, potentially setting up a new front in the Obamacare wars.
Image: US President Donald J. Trump hosts former Secretary of State Henry Kissinger
US President Donald J. Trump (R) shakes hands with former Secretary of State Henry Kissinger (L) during their meeting in the Oval Office of the White House, in Washington, DC on Oct. 10, 2017.Michael Reynolds / EPA

WASHINGTON — President Donald Trump teased an upcoming executive order on health care on Tuesday, potentially setting up a new front in the Obamacare wars that experts worry could destabilize insurance markets.

"With Congress the way it is, I decided to take it upon myself," Trump said at a meeting with former Secretary of State Henry Kissinger, referring to the inability of lawmakers to pass health care reform. "So we'll be announcing that soon as far as the signing is concerned. But it's largely worked out."

Trump offered few details, other than saying that the order would allow people to "cross state lines" to purchase health insurance and that it would "take care of a big percentage of the people we’re talking about" who have been dissatisfied with their coverage under the Affordable Care Act.

Trump joked that it was necessary to protect Kissinger, who is 94, from paying the rising cost of individual plans under Obamacare.

"Henry Kissinger does not want to pay 116 percent increase in his premiums, but that's what's happening," the president said. (As a U.S. citizen over 65, however, Kissinger qualifies for Medicare, making the issue moot in his case.)

Sen. Rand Paul, R-Ky., tweeted on Tuesday that he has been working with the White House on the plan.

Ideas under consideration, according to a Wall Street Journal report, include making association plans for trade groups and businesses available to more individuals. Another plan is to allow people to purchase short-term catastrophic insurance for longer periods.

Depending on the White House's moves, the order could allow many customers to buy cheaper but less comprehensive plans, potentially avoiding regulations in their state on what treatments insurers must cover and how much they can charge people with pre-existing conditions.

Such moves could create less expensive options for healthier customers who earn too much to qualify for federal subsidies, but, by drawing them away from the Obamacare exchanges, the changes could cause premiums for sicker patients to spike and potentially cause some insurers to abandon the individual market entirely.

Insurance companies can already sell plans across states lines under Obamacare if the states in question allow it, but they must meet minimum standards of coverage; insurers have not lined up to use the provision.

Insurers and state regulators have already complained they are raising premiums next year on the Obamacare exchanges in part because of uncertainty over the White House's approach to the law. The administration is drastically scaling back advertising and outreach campaigns to enroll people during the next enrollment period, which begins Nov. 1 and concludes Dec. 15.