Trump's crackdown on Obamacare is accelerating.
Just over 7 hours after his inauguration, late on Friday, the president signed an executive order concerning the 2010 healthcare law, telling reporters the action was meant "to ease the burden of Obamacare as we transition from repeal and replace" and urging U.S. agencies to "waive, defer, grant exemptions from, or delay the implementation" of provisions deemed to impose fiscal burdens on states, companies or individuals.
While the executive order was purposefully vague and served mostly a symbolic role, on Sunday the Trump administration provided some more details on how the "repeal and replace" would look, when Trump aide Kellyanne Conway said the government may no longer enforce the key "Affordable Care Act" rule requiring individual Americans to carry health insurance or pay a penalty if they do not.
Speaking on ABC's "This Week" program, Conway who is a counselor to the president, said Donald Trump "may stop enforcing the individual mandate." Then, on CBS' "Face the Nation" show, she reiterated Republican promises that no one would lose their health insurance under Obamacare while a replacement is being developed.
"For the 20 million who rely upon the Affordable Care Act in some form, they will not be without coverage during this transition time," she said quoted by Reuters.
Also on Sunday, Mitch McConnell repeated Republican promises to replace Obamacare and allow patients to buy health insurance across state lines using health savings accounts. "We’re going to move carefully in conjunction with the administration to repeal and replace it with things like health savings accounts and interstate health insurance sales and high-risk pools at the state level to take care of people who have pre-existing conditions." he said.
Last week Republican Representative Tom Price, Trump's nominee to lead the Department of Health and Human Services, told the Senate Committee on Health, Education, Labor and Pensions, that an overhaul of Obamacare will initially focus on individual health plans sold on online exchanges and the Medicaid health insurance program for low-income Americans.
He added that the revamp would not immediately tackle changes to Medicare, the federal health insurance program for those 65 and older and people with disabilities.
Trump has previously said he wants to keep some elements of Obamacare, such as allowing young adults to be covered under their parents' insurance. He is in favor of plans that use health savings accounts and the sale of insurance across state lines. A bigger question is once the administration moves beyond the repeal phase, just how long would the replace phase take: as a reminder, a full replacement would require bipartisan support, and at the current time that appears very much improbable, which is why Goldman, and others, speculated that the replacement of Obamacare could take as long as 2 years, and may bog down much of Trump's fiscal agenda.
If so, much of what the market has priced in will have to be "unpriced" quickly, as Trump focuses exclusively on undoing 8 years of Obama tinkering with the US health insurance system.