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the President also issued an Executive Order requiring that federal agencies identify two existing regulations to be repealed for any new regulation they propose.
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Published by Lisa Kaplan Howe
Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News.
Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.
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