While President Donald Trump's first executive order on the Affordable Care Act aimed to weaken the law he plans to see repealed, its immediate impact may be muted.
According to Timothy Jost, a professor at the Washington and Lee University School of Law, and co-author of the textbook "Health Law," any desired changes to the ACA through executive order have to comply with the Administrative Procedures Act and other statutes.
Writing for Health Affairs, Jost said nothing will change until the incoming secretaries of Health and Human Services, Treasury and Labor have taken their posts, as well as the Centers for Medicare and Medicaid Administration and the IRS Commissioner.
[Also: ACA opponents see Trump as fix for health law's woes]
Long-term changes of course are likely, and Jost expects there may be a change in the interpretation of section 1332 of the ACA, which allows HHS to grant innovation waivers to states. But if the ACA, or at least that section, stays intact, waivers will still have to be granted.
New categories of hardship exemptions to the individual responsibility requirement may be created, he said, but they'd have to qualify as hardships. Section 1115 Medicaid waivers will be granted more liberally, "but that was expected," he wrote, "and until they are changed, 1115 waiver regulations promulgated by the Obama administration will continue to apply."
One thing that would be unfortunate, in Jost's view, is for the individual responsibility requirement to be repealed. That could be devastating to the individual insurance market if isn't replaced by an alternative means of encouraging healthy people to enroll.
Jost sees many in Congress as being perplexed as to how to proceed with an ACA repeal-and-replace plan, and that they'll see Trump's executive action as a means of buying time while they hash out the details.
Twitter: @JELagasse