Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

This executive order directs federal agencies to use all available legal authority to waive, delay, or exempt parties from provisions of the Affordable Care Act that impose fiscal or regulatory burdens, while also encouraging state flexibility and interstate healthcare markets. It was issued on President Trump's first day in office with the stated goal of minimizing economic burdens pending congressional repeal of the ACA.

Federal Register Open PDF 82 FR 8351

Key directives

Secretary of HHS and agency heads shall waive, defer, grant exemptions from, or delay ACA provisions imposing fiscal or regulatory burdens
Agencies shall provide greater flexibility to States in implementing healthcare programs
Agency heads shall encourage development of free and open interstate market for healthcare services and insurance
Regulatory revisions must comply with Administrative Procedure Act notice-and-comment requirements

Who is ordered

Timeline

Immediate

Agencies directed to begin exercising waiver and deferral authority
Policy statement establishing repeal as administration goal

Near term (90d)

Potential regulatory revisions subject to APA notice-and-comment requirements
State flexibility initiatives to be developed

Long term

Continued erosion of ACA implementation pending legislative repeal
Potential establishment of interstate healthcare markets

Risks & tensions

Order invites legal challenge by directing non-enforcement of duly enacted statute; 'to the maximum extent permitted by law' qualifier may limit actual authority
Tension between prompt repeal goal and 'efficient implementation' language in Section 1
APA compliance requirement (Sec. 5) creates procedural barrier to rapid deregulatory action
Non-enforceability clause (Sec. 6(c)) limits private party reliance on any exemptions granted