In a follow up to several other executive orders1 and statements issued by the White House over the past two years, President Trump delivers new directives in his next chapter of 'putting Americans first.'
Since taking office, the President has set his sights on improving health care and health care outcomes for Americans. This brief retrospective provides a look at his path and message:
1/20/17 – Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal
Instructs regulatory agencies to make every effort possible to delay, change, or eliminate any provisions of the ACA that imposes a “cost, fee, penalty or regulatory burden.”
10/12/17 – Executive Order to Promote Healthcare Choice and Competition
Modifies the Affordable Care Act (ACA) by requesting information on the feasibility of expanding association health plans (AHPs), short-term limited duration insurance and health reimbursement arrangements (HRAs) and taking action to implement these enhancements
Defining parameters under which a patient should not be held accountable for large out-of-pocket costs due to lack of ability to choose a network physician in certain emergency or planned health care services for which the hospital chooses the provider of service without consent of the patient, e.g. anesthesiologist, radiologists, or pathologists associated with a network hospital but who, themselves, are not in the network and for whom the individual has no option of selection
Eliminating the ability for pharmacy benefit managers (PBMs) and insurance companies to prohibit pharmacists from disclosing more cost-effective drug price information to plan enrollees when it is cheaper to purchase a drug without using the insurance plan
10/25/18 – American Patients First
The President and U.S. Department of Health and Human Services (HHS) Secretary, Alex Azar, release a comprehensive plan to bring down prescription drug prices and out-of-pocket costs
The newest executive order released 6/24/19, Improving Price and Quality Transparency in American Healthcare to Put Patients First, builds on the previous executive orders and last month’s principles addressing the inequities of cost and treatment information available to the American Patient and demanding transparency.
We should also require drug companies, insurance companies, and hospitals to disclose real prices to foster competition and bring costs down.
– President Donald J. Trump
Specifically, the order directs the Secretary of HHS to:
- Propose a regulation, within 60 days, to require hospitals to publicly disclose standard charge amounts, including any negotiated rates for common shoppable items and services in a consumer-friendly manner using standard data and tools and to update that information regularly;
- Work with the Secretaries of Treasury and DOL to solicit comments, within 90 days, on a proposal that requires all healthcare providers, health insurers, self-insured health plans provide information on expected out-of-pocket costs for items or services to patients prior to receiving care;
- Issue a report in consultation with the Attorney General, and Federal Trade Commission (FTC), within 180 days, regarding the federal government or private sector impediments to healthcare pricing transparency for patients and providing remedies that will promote competition;
- Develop a Health Quality Roadmap, within 180 days and in collaboration with Secretaries of Defense and Veterans Affairs, aligning and improving and reporting on data and quality measures across Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), the Health Insurance Marketplace (Exchange), the Military Health System, and the Veterans Affairs Health System;
- Increase access to de-identified claims data from taxpayer-funded healthcare programs and group health plans for researchers, innovators, providers, and entrepreneurs, within 180 days and in consultation with the Secretaries of Treasury, Defense, Labor, and Veteran’s Affairs, that ensures patient privacy and security for the purpose of developing tools to empower patients to have more information at their fingertips in order to make good decisions about healthcare goods and services; and
- Submit a report to the President, within 180 days, on additional steps necessary to implement the principles on surprise medical billing announced on May 9, 2019
Additionally, the executive order directs the Secretary of Treasury to create the following:
- Issue guidance, within 120 days, to expand the ability of patients to select high-deductible health plans (HDHPs) that can be used alongside a health savings account (HSA) that cover low-cost preventive care, before the deductible, for medical care that helps health status for people with chronic conditions;
- Propose regulations, within 180 days, to treat expenses related to certain arrangements, potentially including direct primary care and health care sharing ministries, as eligible medical expenses under section 213(d);2 and
- Issue guidance, within 180 days, to increase the amount of funds that can carry over without a penalty at year end for flexible spending accounts (FSAs)
We will be watchful for each of these actions and steps in the upcoming months and what that may mean to each of our clients, their employees and benefits plans. Be sure to visit OneDigital’s Compliance Confidence blog so you don’t miss an update.
To read the President’s summary of the executive order, click here.
1. [Executive Order - While an executive order is not a law, it sets the tone for Congress and the regulatory agencies, like the Department of Health and Human Resources (HHS), the Internal Revenue Service (IRS), and the Department of Labor (DOL). It provides instruction and prioritization to regulatory agencies for new rules and, on Congressional activities, insight as to whether the President will sign or veto certain bills.]↩
2. [Expenses eligible for reimbursement under tax-preferred plans, such as flexible spending accounts (FSAs), HRAs, and HSAs] ↩