President Trump signed an executive order on Thursday that critics say will sabotage the Obamacare insurance markets.
Trump is directing the Secretaries of Labor, Treasury and Health and Human Services to expand programs to allow small businesses to group together to buy insurance plans across state lines.
"This will cost the U.S. virtually nothing and people will have great, great health care," Trump said.
Small businesses and people who are self-employed will be able to join together to form "association health plans" across state lines. The groups can use their collective bargaining power to negotiate with insurance companies to get cheaper insurance plans. Insurers will be able to offer plans that do not meet all of the current coverage requirements under the affordable care act.
"President Trump is doing what I believe is the biggest free-market reform of health care in a generation," said Sen. Rand Paul (R-Ky.), who has been working on the proposal with Trump for several weeks.
The executive order will also allow employers to expand Health Reimbursement Arrangements, employer-funded accounts that reimburse employees for health care expenses, including deductibles and co-payments, pre-tax.
It will also expand the use of short-term insurance policies, which offer minimal coverage as a bridge for people who have a gap in coverage.
Trump said the executive order was just the first step to freeing millions of Americans from "unaffordable" Obamacare insurance plans. He said his administration would be taking new measures in the coming months "to provide our people with even more freedom."
But critics say the order will encourage healthy Americans to flee the Obamacare insurance pool and flock to cheaper plans, driving up prices for Americans with illnesses and pre-existing conditions.
"For me, without insurance, my medical care would cost more than $30,000 a month," said Hannah Fakcnitz, 26, a college student who was diagnosed with lupus four years ago.
"It's not just like, I'm angry because it's wrong," she said, "I'm angry because that's my life."
Facknitz says she doesn't know what will happen to her health insurance now that the executive order has been signed, but worries her family will have to make tough decisions in order to keep her alive.
"It means my dad, who just retired and my mom who's retired, going back to work full time in order to pay for my health insurance," she said. "It would mean giving up dreams of going to graduate school, maybe not even being able to graduate from undergrad that I'm working on now."
But premiums under Obamacare have already become unaffordable for other Americans.
"I don't want people not being able to have health care coverage, I really don't. But I also don't want to sell a car to pay for someone with a pre-exiting condition," said Nikki Mosteller, 52.
Mosteller, a self-employed real estate worker living in Tennessee, says her monthly insurance rate is nearly $1,473.
"If the option is him signing the executive order and us at least having some type of coverage versus a policy that is absolutely unaffordable and unusable, we're going to one hundred percent back this decision," she said.
It's unclear how the order will be carried out and when it will take effect. Paul told reporters on Thursday the order might not go into effect until 2019.
President Trump signs an executive order on health care.
President Trump is set to sign an executive order on Thursday that will allow individuals and small businesses to group together to buy health insurance across state lines. The order will also allow insurers to offer those groups cheaper plans that do not meet all of the Affordable Care Act's coverage requirements.
The order is expected to closely resemble a proposal from Sen. Rand Paul (R-KY), who has been advocating for the expansion of "association health plans." Paul planned to vote against the GOP's last bill to repeal and replace Obamacare.
Trump told reporters last week that he was considering signing such an order and tweeted that he was planning to use the "power of the pen" to fix health care.
Since Congress can't get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people - FAST— Donald J. Trump (@realDonaldTrump) October 10, 2017
Critics say the order will effectively sabotage the insurance markets by drawing healthier Americans to cheaper plans and leaving the sickest people in the Obamacare insurance markets with unaffordable premiums.
The order will expand the use of short-term insurance policies, which offer minimal coverage as a bridge for people who have a gap in coverage. It will also encourage employers to expand Health Reimbursement Arrangements, employer-funded accounts that reimburse employees for health care expenses, including deductibles and co-payments, pre-tax.
The order will likely be met with legal challenges.
It's unclear how the order will affect bipartisan efforts in the Senate to fix problems with the Affordable Care Act, and several senators have other health care proposals on the table.