This action is separate from the decision by Trump to cut off payments to insurance companies to subsidize moderate to lower income policy holders who buy insurance through the ACA exchanges. This action has an immediate effect, unlike the signing of the Executive Order that calls for changes to healthcare regulations. The process of changing federal regulations can take months to years to implement.
An article in Kaiser Health News (KHN), “Trump’s Order Advances GOP Go -To Ideas To Broaden Insurance Choices, Curb Costs”, by Judy Appleby, 10/12/17, explains the intent of this particular order as well as other details including the pros and cons:
“The Trump administration Thursday advanced a wide-ranging executive order aimed at expanding lower-cost insurance options, allowing employers to give workers money to buy their own coverage and slowing consolidation in the insurance and hospital industries.
“Critics said that, if implemented, the changes could result in more bare-bones coverage and pull healthier people out of the already struggling insurance markets, leading to higher premiums for those who remain in more-regulated coverage.
“President Donald Trump’s action, which will not take effect in time to affect the upcoming open enrollment for coverage in 2018, signals a shift in the administration’s strategy, which relied on Congress to repeal the Affordable Care Act. Trump is now using the force of his executive rule-making authority to implement long-favored GOP policy alternatives.” [emphasis added]
Before there is widespread panic that millions will immediately lose their health insurance, the good news is that it will take some time before that happens and perhaps agreements between Congress and the President to shore up Obamacare will occur before this policy can go into effect. The bad news is that judging by the current state of this debate, such an agreement is highly unlikely.
What is an Executive Order?
This is from Wikipedia:
An article in Kaiser Health News (KHN), “Trump’s Order Advances GOP Go -To Ideas To Broaden Insurance Choices, Curb Costs”, by Judy Appleby, 10/12/17, explains the intent of this particular order as well as other details including the pros and cons:
“The Trump administration Thursday advanced a wide-ranging executive order aimed at expanding lower-cost insurance options, allowing employers to give workers money to buy their own coverage and slowing consolidation in the insurance and hospital industries.
“Critics said that, if implemented, the changes could result in more bare-bones coverage and pull healthier people out of the already struggling insurance markets, leading to higher premiums for those who remain in more-regulated coverage.
“President Donald Trump’s action, which will not take effect in time to affect the upcoming open enrollment for coverage in 2018, signals a shift in the administration’s strategy, which relied on Congress to repeal the Affordable Care Act. Trump is now using the force of his executive rule-making authority to implement long-favored GOP policy alternatives.” [emphasis added]
Before there is widespread panic that millions will immediately lose their health insurance, the good news is that it will take some time before that happens and perhaps agreements between Congress and the President to shore up Obamacare will occur before this policy can go into effect. The bad news is that judging by the current state of this debate, such an agreement is highly unlikely.
What is an Executive Order?
This is from Wikipedia:
Executive Orders are presidential directives issued by United States Presidents and are generally directed towards officers and agencies of the U.S. federal government. Executive orders may have the force of law, if based on the authority derived from statute or the Constitution itself. The ability to make such orders is also based on express or implied Acts of Congress that delegate to the President some degree of discretionary power (delegated legislation).[1]
Like both legislative statutes and regulations promulgated by government agencies, executive orders are subject to judicial review and may be overturned if the orders lack support by statute or the Constitution.[2] Major policy initiatives require approval by the legislative branch, but executive orders have significant influence over the internal affairs of government, deciding how and to what degree legislation will be enforced, dealing with emergencies, waging wars, and in general fine-tuning policy choices in the implementation of broad statutes.
If you have doubts about whether Wikipedia is an authoritative source of information, that depends on the subject. This entry jibes with what I have read before about executive orders and I’m sure there are many other authoritative sources to confirm the information.
Like both legislative statutes and regulations promulgated by government agencies, executive orders are subject to judicial review and may be overturned if the orders lack support by statute or the Constitution.[2] Major policy initiatives require approval by the legislative branch, but executive orders have significant influence over the internal affairs of government, deciding how and to what degree legislation will be enforced, dealing with emergencies, waging wars, and in general fine-tuning policy choices in the implementation of broad statutes.
If you have doubts about whether Wikipedia is an authoritative source of information, that depends on the subject. This entry jibes with what I have read before about executive orders and I’m sure there are many other authoritative sources to confirm the information.
How does the federal rule making process work and what does this have do with you?
There’s nothing like a civics lesson to take your mind off the horrifying prospect that your family member with a disability and who-knows-how-many pre-existing conditions, could be priced out of health insurance or denied it altogether.
One way that people with disabilities and their families can have an impact on proposed changes to healthcare is through opportunities afforded for public comment during the rule making process.
One way that people with disabilities and their families can have an impact on proposed changes to healthcare is through opportunities afforded for public comment during the rule making process.
“The Guide to the RulemakingProcess”, prepared by the Office of the Federal Register, is a handy tool for individuals and organizations that want to follow and comment on proposed changes to federal regulations.
Here is another handy definition from Wikipedia:
“The Federal Register, abbreviated FR or sometimes Fed. Reg., is the official journal of the federal government of the United States that contains government agency rules, proposed rules, and public notices.[1] It is published daily, except on federal holidays. The final rules promulgated by a federal agency and published in the Federal Register are ultimately reorganized by topic or subject matter and codified in the Code of Federal Regulations (CFR), which is updated annually.”
Here are a few excerpts from “The Guide to the Rulemaking Process” that will help assure your participation:
How does an agency involve the public in developing a proposed rule?
An agency may take some preliminary steps before issuing a proposed rule. They gather information through unstructured processes and informal conversations with people and organizations interested in the issues. If an agency receives a “Petition for Rulemaking” from a member of the public, it may decide to announce the petition in the Federal Register and accept public comments on the issue.
An agency that is in the preliminary stages of rulemaking may publish an “Advance Notice of Proposed Rulemaking” in the Federal Register to get more information. The Advance Notice is a formal invitation to participate in shaping the proposed rule and starts the notice‐and-comment process in motion.
Anyone interested (individuals and groups) may respond to the Advance Notice by submitting comments aimed at developing and improving the draft proposal or by recommending against issuing a rule. Some agencies develop proposed rules through a negotiated rulemaking. In this process, an agency invites members of interested groups to meetings where they attempt to reach a consensus on the terms of the proposed rule. If the participants reach agreement, the agency may endorse their ideas and use them as the basis for the proposed rule.
What is the role of the President in developing a proposed rule?
Before a proposed rule is published in the Federal Register for public comment, the President, as head of the Executive branch, may take the opportunity to review the rule. The President is assisted by the Office of Information & Regulatory Affairs (OIRA), which analyzes draft proposed rules when they are “significant” due to economic effects or because they raise important policy issues. For significant rules, the agency must estimate the costs and benefits of the rule and consider alternate solutions….
What is the purpose of the proposed rule?
The proposed rule, or Notice of Proposed Rulemaking (NPRM), is the official document that announces and explains the agency’s plan to address a problem or accomplish a goal. All proposed rules must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The proposed rule and the public comments received on it form the basis of the final rule.
What is the time period for the public to submit comments?
Here is another handy definition from Wikipedia:
“The Federal Register, abbreviated FR or sometimes Fed. Reg., is the official journal of the federal government of the United States that contains government agency rules, proposed rules, and public notices.[1] It is published daily, except on federal holidays. The final rules promulgated by a federal agency and published in the Federal Register are ultimately reorganized by topic or subject matter and codified in the Code of Federal Regulations (CFR), which is updated annually.”
Here are a few excerpts from “The Guide to the Rulemaking Process” that will help assure your participation:
How does an agency involve the public in developing a proposed rule?
An agency may take some preliminary steps before issuing a proposed rule. They gather information through unstructured processes and informal conversations with people and organizations interested in the issues. If an agency receives a “Petition for Rulemaking” from a member of the public, it may decide to announce the petition in the Federal Register and accept public comments on the issue.
An agency that is in the preliminary stages of rulemaking may publish an “Advance Notice of Proposed Rulemaking” in the Federal Register to get more information. The Advance Notice is a formal invitation to participate in shaping the proposed rule and starts the notice‐and-comment process in motion.
Anyone interested (individuals and groups) may respond to the Advance Notice by submitting comments aimed at developing and improving the draft proposal or by recommending against issuing a rule. Some agencies develop proposed rules through a negotiated rulemaking. In this process, an agency invites members of interested groups to meetings where they attempt to reach a consensus on the terms of the proposed rule. If the participants reach agreement, the agency may endorse their ideas and use them as the basis for the proposed rule.
What is the role of the President in developing a proposed rule?
Before a proposed rule is published in the Federal Register for public comment, the President, as head of the Executive branch, may take the opportunity to review the rule. The President is assisted by the Office of Information & Regulatory Affairs (OIRA), which analyzes draft proposed rules when they are “significant” due to economic effects or because they raise important policy issues. For significant rules, the agency must estimate the costs and benefits of the rule and consider alternate solutions….
What is the purpose of the proposed rule?
The proposed rule, or Notice of Proposed Rulemaking (NPRM), is the official document that announces and explains the agency’s plan to address a problem or accomplish a goal. All proposed rules must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The proposed rule and the public comments received on it form the basis of the final rule.
What is the time period for the public to submit comments?
In general, agencies will specify a comment period ranging from 30 to 60 days in the “Dates” section of the Federal Register document, but the time period can vary. For complex rulemakings, agencies may provide for longer time periods, such as 180 days or more. Agencies may also use shorter comment periods when that can be justified.
Members of the public may request that the agency allow more time to submit comments, and agencies may consider late‐filed comments, if their decision‐making schedule permits it. Commentors should be aware that agencies generally are not legally required to consider late filed comments. Agencies usually provide information in the proposed rule and/or their procedural rules indicating whether they will consider late‐filed comments.
Do agencies have additional options for gathering public comments?
During the comment period, an agency may also hold public hearings where people can make statements and submit data. Some agencies operate under laws that require rulemaking hearings. Others may hold public meetings to collect more information or to help affected groups get a better understanding of the proposed rule. Many agencies are beginning to use webcasts and interactive Internet sessions to broaden the audience attending public meetings.
After the comment period closes, an agency may establish a second period for reply comments (comments that respond to prior comments). A reply period is not required by law. The reply comment period enables people to respond to comments that agencies received at the end of comment period, creating more of a public dialog.
How do public comments affect the final rule?
The notice‐and‐comment process enables anyone to submit a comment on any part of the proposed rule. This process is not like a ballot initiative or an up‐or‐down vote in a legislature. An agency is not permitted to base its final rule on the number of comments in support of the rule over those in opposition to it. At the end of the process, the agency must base its reasoning and conclusions on the rulemaking record, consisting of the comments, scientific data, expert opinions, and facts accumulated during the pre‐rule and proposed rule stages.
To move forward with a final rule, the agency must conclude that its proposed solution will help accomplish the goals or solve the problems identified. It must also consider whether alternate solutions would be more effective or cost less.
If the rulemaking record contains persuasive new data or policy arguments, or poses difficult questions or criticisms, the agency may decide to terminate the rulemaking. Or, the agency may decide to continue the rulemaking but change aspects of the rule to reflect these new issues. If the changes are major, the agency may publish a supplemental proposed rule. If the changes are minor, or a logical outgrowth of the issues and solutions discussed in the proposed rules, the agency may proceed with a final rule.
How is the final rule structured?
Final rules also have preambles, including the summary, effective date, and supplementary information. The final rule published in the Federal Register begins with a “Summary” of the societal problems and regulatory goals and explains why the rule is necessary.
Every final rule must have an “Effective Date.” However, any portions that are subject to later approval under the Paperwork Reduction Act or are subject to Congressional approval may be excepted from that effective date. The “Dates” caption in the Federal Register may also contain compliance or applicability dates.
The agency must state the “basis and purpose” of the rule in the “Supplementary Information” part of the preamble. This statement sets out the goals or problems the rule addresses, describes the facts and data the agency relies on, responds to major criticisms in the proposed rule comments, and explains why the agency did not choose other alternatives.
The agency must identify its legal authority for issuing the rule and publish the regulatory text in full. The regulatory text sets out amendments to the Code of Federal Regulations (CFR). Each amendment begins with instructions for changing the CFR.
Members of the public may request that the agency allow more time to submit comments, and agencies may consider late‐filed comments, if their decision‐making schedule permits it. Commentors should be aware that agencies generally are not legally required to consider late filed comments. Agencies usually provide information in the proposed rule and/or their procedural rules indicating whether they will consider late‐filed comments.
Do agencies have additional options for gathering public comments?
During the comment period, an agency may also hold public hearings where people can make statements and submit data. Some agencies operate under laws that require rulemaking hearings. Others may hold public meetings to collect more information or to help affected groups get a better understanding of the proposed rule. Many agencies are beginning to use webcasts and interactive Internet sessions to broaden the audience attending public meetings.
After the comment period closes, an agency may establish a second period for reply comments (comments that respond to prior comments). A reply period is not required by law. The reply comment period enables people to respond to comments that agencies received at the end of comment period, creating more of a public dialog.
How do public comments affect the final rule?
The notice‐and‐comment process enables anyone to submit a comment on any part of the proposed rule. This process is not like a ballot initiative or an up‐or‐down vote in a legislature. An agency is not permitted to base its final rule on the number of comments in support of the rule over those in opposition to it. At the end of the process, the agency must base its reasoning and conclusions on the rulemaking record, consisting of the comments, scientific data, expert opinions, and facts accumulated during the pre‐rule and proposed rule stages.
To move forward with a final rule, the agency must conclude that its proposed solution will help accomplish the goals or solve the problems identified. It must also consider whether alternate solutions would be more effective or cost less.
If the rulemaking record contains persuasive new data or policy arguments, or poses difficult questions or criticisms, the agency may decide to terminate the rulemaking. Or, the agency may decide to continue the rulemaking but change aspects of the rule to reflect these new issues. If the changes are major, the agency may publish a supplemental proposed rule. If the changes are minor, or a logical outgrowth of the issues and solutions discussed in the proposed rules, the agency may proceed with a final rule.
How is the final rule structured?
Final rules also have preambles, including the summary, effective date, and supplementary information. The final rule published in the Federal Register begins with a “Summary” of the societal problems and regulatory goals and explains why the rule is necessary.
Every final rule must have an “Effective Date.” However, any portions that are subject to later approval under the Paperwork Reduction Act or are subject to Congressional approval may be excepted from that effective date. The “Dates” caption in the Federal Register may also contain compliance or applicability dates.
The agency must state the “basis and purpose” of the rule in the “Supplementary Information” part of the preamble. This statement sets out the goals or problems the rule addresses, describes the facts and data the agency relies on, responds to major criticisms in the proposed rule comments, and explains why the agency did not choose other alternatives.
The agency must identify its legal authority for issuing the rule and publish the regulatory text in full. The regulatory text sets out amendments to the Code of Federal Regulations (CFR). Each amendment begins with instructions for changing the CFR.
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Despite the promise of public involvement in federal rulemaking, there has not been any inclination on the part of the President or the majority in Congress to solicit opinions or advice from the general public, or even from people directly affected by proposed changes in healthcare policy. It is hard to tell where all this leading. The best advice is to Expect the Unexpected.
Despite the promise of public involvement in federal rulemaking, there has not been any inclination on the part of the President or the majority in Congress to solicit opinions or advice from the general public, or even from people directly affected by proposed changes in healthcare policy. It is hard to tell where all this leading. The best advice is to Expect the Unexpected.
