Following are some preliminary thoughts on the Executive Order released on October 12, 2017, by President Trump:

1. The primary emphasis of the Executive Order is to reduce costs for both employers and individuals. The Affordable Care Act, in contrast, emphasized, and made great strides in, expanding insurance coverage for millions of Americans.
2. The Executive Order instructs the United States Department of Labor to consider proposing regulations or revising guidance to allow more employers to form association health plans. Many employers utilize association health plans to increase bargaining power and minimize volatility related to health insurance. However, since passage of the Affordable Care Act, the Department of Labor increased its scrutiny of association health plans and expanded its enforcement efforts. The Executive Order potentially reflects a sea change in how association health plans will be viewed by the federal government.
3. The Executive Order instructs various federal agencies to enhance the availability of short-term, limited-duration insurance. Recent federal guidance restricted the availability of these limited insurance plans to three months or less. The Executive Order encourages the federal agencies to consider expanding the duration of these policies and to allow them to be renewed by consumers.
4. The Executive Order finally instructs various federal agencies to consider proposing regulations or revising guidance relating to health reimbursement arrangements (HRA). An HRA is an employer-funded arrangement that reimburses employees and certain family members for medical care expenses. The Affordable Care Act significantly limited the utility of HRAs. The Executive Order specifically directs the agencies “to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.”
5. It is important to recognize that the Executive Order, by itself, does not alter any statute or regulation. However, it does start the wheels of the federal government turning to provide employers with more options to provide affordable coverage to their employees.