Trump preparing executive orders on health care this week

By Susannah Luthi , Daniel Lippman , Dan Diamond 09/22/2020 02:51 PM EDT Updated: 09/22/2020 03:03 PM EDT

President Donald Trump is planning to announce a series of executive actions on health care as soon as Thursday, as he tries to shore up his record on an issue that’s been a drag on his reelection effort.

One of the executive actions could include a promised order meant to safeguard insurance protections for pre-existing conditions should the Supreme Court undercut Obamacare, according to seven people familiar with the discussions, including three administration sources. Other executive actions under consideration include efforts to prevent patients from receiving “surprise” medical bills and an effort to address mental health.

The details of the announcement are still in flux, the sources stressed. The moves could come as a comprehensive package or a series of individual orders. The plan is for Trump to make the announcements during an event Thursday afternoon in North Carolina where the focus is health care.

Trump over the past two months has promised a replacement plan for Obamacare that hasn’t materialized, even as his administration urges the Supreme Court to overturn the health care law in a case the justices are scheduled to hear a week after Election Day. Trump and Republicans, particularly senators in tough reelection races, are facing renewed urgency to explain how they would protect popular insurance protections after the death of Justice Ruth Bader Ginsburg increased the odds the Supreme Court could invalidate Obamacare — or at least significant portions of the law. Trump is pushing hard to get his eventual nominee on the court by the time the court hears oral arguments.

Trump and Republicans have regularly promised to safeguard insurance protections, but they have failed to agree on a health plan three years after congressional efforts to repeal Obamacare fell apart. Previous Republican health plans have included some language around preexisting conditions, but they fell short of Obamacare’s robust guarantees. Polls show that voters trust Democrats, including presidential nominee Joe Biden, more than Trump on health care by a significant margin.

White House press secretary Kayleigh McEnany during a Tuesday press conference said that Trump is working on a health plan that will be unveiled soon, but she declined to provide more specific timing.

“The president in the next week or so will be laying out his vision for health care,” she said.

The executive actions are likely to have limited reach and impact before the election, industry observers said. A series of drug pricing orders Trump released in the past two months, including one that would link Medicare prices to cheaper ones paid overseas, largely tee up a federal rulemaking process that would take months, if not years, to come into force.

“Remember an executive order is just that — an order or command for agencies to release rulemaking — so this won’t be it, if Trump is trying to create real reform,” said Ipsita Smolinski, managing director for the Washington analysis firm Capitol Street, noting that the administration has yet to issue regulations that would give legs to Trump’s drug pricing proposals.page1image17941248

Drug pricing and health costs remain a top concern for voters, but efforts to address those issues fell apart in a polarized Congress and as the coronavirus pandemic swamped other priorities. Bipartisan legislation to prevent surprise billing, once considered an easy fix for this Congress, was derailed by intense opposition from health care provider groups who feared they’d bear the brunt of the cost.

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