Experts: Trump Executive Order Could Complete Sabotage of ACA Marketplaces, Increasing Costs and Devastating Americans with Preexisting Conditions  

Healthcare experts are warning that the executive order Donald Trump will reportedly sign Thursday would catastrophically destabilize Affordable Care Act marketplaces, hammering Americans suffering from preexisting conditions and causing premiums to skyrocket.

This executive order will ruin the American healthcare system,” said American Bridge spokesperson Andrew Bates. “It will devastate millions of Americans who suffer from preexisting conditions and drive healthcare costs up only because Donald Trump has chosen to put his cynical political agenda ahead of the country’s medical and financial well-being. This is a tragedy in the making for countless families, and they will hold Donald Trump and his Republican enablers in Congress accountable for it.”

Trump and his administration have taken a large series of executive actions that have damaged Affordable Care Act insurance markets and that will raise healthcare costs for millions of Americans, including cutting the overall enrollment ad budget by 90% as well as community outreach funds by 40%halving the enrollment period in most states, and ceasing Health and Human Services participation in enrollment events.

Trump has also repeatedly threatened to withhold cost-sharing reductions (CSRs), which are critical in order for 7 million working people to afford healthcare – and without which the premiums for benchmark marketplaces silver plans would skyrocket by up to 25%.

America’s doctors, hospitals, industry leaders, insurance companies, and others have strongly urged to Trump to stop sending marketplaces into chaos, but instead he has intensified his sabotage of the ACA for partisan reasons, and it’s costing innocent people. 

As the experts quoted below illustrate, this week’s executive order would be by far the most egregious step in these efforts to undermine the law.


Northwestern University’s Kellogg School of Management Healthcare Program Director Craig Garthwaite: “It unwinds the ability of people with pre-existing conditions to get insurance under the ACA.” [Reuters, 10/10/2017]

American Academy of Actuaries Senior Fellow Cori Uccello: “It would deteriorate the risk pool, lead to increased premiums, more instability and potentially make insurers have to make decisions on whether they’re going to continue to participate.” [Politico, 10/10/2017]

Brookings Institute Center for Health Policy Fellow Matt Friedler:“Associations would siphon many healthier people out of the ACA-compliant market, driving up premiums…Higher premiums in the ACA-compliant market would result in big cost increases for many sicker enrollees — since they would not have the option of switching to the association market — and likely for the federal government as well.” [Bloomberg, 10/10/2017]

Kaiser Family Foundation Healthcare Marketplace Project Director Gary Claxton: “If the market’s already fragile right now, this is going to make it much more fragile…All of this would be the start of the end of the individual ACA market.” [Bloomberg, 10/10/2017]

Bloomberg: “An executive order from President Donald Trump to allow new health plans outside of Obamacare could further destabilize the law’s fragile markets, health-care experts say.” [Bloomberg, 10/10/2017]

Wall Street Journal: “One result, analysts said, could be that healthy people are drawn to the expanded, less-expensive plans, leaving sicker and higher-risk people in a dwindling pool that sees higher costs. Together, if executed in an expansive way, Mr. Trump’s changes could ‘cause a bifurcation of the market,’ said Cori Uccello, senior health fellow at the American Academy of Actuaries.” [Wall Street Journal, 10/9/2017]

Rhett Buttle, Former Department of Health and Human Services Director of Private Sector Engagement (Obama Administration): “I agree that we need to find more options for small business, but AHPs are not the answer. They allow cherry picking that could undermine the traditional small group market…Additionally, they could lead to premium instability for small businesses and put some of their consumer protections at risk.” [Wall Street Journal, 10/9/2017]

Urban Institute Health Policy Center Senior Fellow Linda Blumberg: “The risks of trying to do the kinds of things we’re hearing about are really tremendous.” [The Street, 10/10/2017]

Courthouse News: “Trump’s coming mandate could also lead to spikes in Obamacare premiums, and may spook large insurers to consider dropping out of the ACA altogether, a move that would starkly divide the insurance market while bringing the White House closer to its hard-fought goal: dismantling Obama’s health care law.” [Courthouse News, 10/10/2017]

Kaiser Family Foundation Vice President Larry Levitt: “Association plans exempt from the ACA can cherry pick healthy people and make coverage unaffordable for those with pre-existing conditions.” [Twitter, 10/10/2017]

  • Kaiser Family Foundation Vice President Larry Levitt: “If loosely regulated association plans are allowed, insurers will leave the ACA marketplaces as soon as they can or hike premiums a lot.” [Twitter, 10/10/2017]

  • Kaiser Family Foundation Vice President Larry Levitt: “Middle class people with pre-existing conditions ineligible for ACA subsidies could be especially vulnerable under the executive order.” [Twitter, 10/10/2017]

Former CMS Administrator Andy Slavitt: “10/ The EO allows “association health plans”– ability for plans to be offered with no pre-ex protections & turn ACA into a high risk pool. [Twitter, 10/5/17]

  • Former CMS Administrator Andy Slavitt: “11/ In states that have done things like this, like TN, premiums have skyrocketed and competitors have left the market.” [Twitter, 10/5/17]

Center For American Progress Vice President Topher Spiro: “1: This executive order will offer CRAPPY health care, SPIKE premiums for people with pre-existing conditions, and DESTABILIZE markets…” [Twitter, 10/10/17]