"Forget it. Frame it. It's worthless." (updated)


(sigh) Back on August 7th (an eternity ago), the "Big News" of the day was that Donald Trump was supposedly going to "pursue a major executive order requiring health insurance companies to cover pre-existing conditions for all of its customers."

As I, and everyone else who has the slightest clue about how health insurance or the law works noted:


ANY reporter/media outlet which reports/tweets about Trump's XO "ordering" insurance companies to "cover pre-existing conditions" without mentioning that THE ACA ALREADY DOES THIS and TRUMP IS SUING TO STRIKE DOWN THE ACA is guilty of journalistic malpractice.

However, even if the Trump Administration wasn't currently supporting a lawsuit to strike down the only federal law which mandates coverage of pre-existing conditions, it's irrelevant because an executive order of this nature is utterly meaningless.

Based on the White House press call, Donald Trump's health care plan amounts to:

  • Trust Donald Trump to cover preexisting conditions
  • Work with Congress to try to get surprise medical billing fixed

— Dylan Scott (@dylanlscott) September 24, 2020

On the first bullet point, I'm not really exaggerating: Trump's EO will state that "it is the policy of the United States" that people with preexisting conditions will be protected, but there is no mechanism I can identify to make sure that happens

— Dylan Scott (@dylanlscott) September 24, 2020

This would do absolutely nothing.

The President's coming EO on pre-existing conditions will simply state that it is the policy of the U.S. that people with pre-existing conditions will be protected, even if ACA is overturned. That's NOT the way this works. This. Requires. Legislation.

— julie rovner (@jrovner) September 24, 2020

The technical policy terms that come to mind regarding reports of President Trump's executive order on pre-existing condition protections:

Pixie dust
Magic wand
Wing and a prayer
Clicking your heels together three times
Making a wish blowing out blowing out birthday candles

— Larry Levitt (@larry_levitt) September 24, 2020

Say it loud, people. Unless President Trump is exercising a power that's been specifically delegated to him, an executive order directed at private parties has no more legal weight than a press release. https://t.co/AyfAGYFjzh

— Nicholas Bagley (@nicholas_bagley) September 24, 2020

The *only* point is to grab a headline that "President Trump issues executive order to protect people with preexisting conditions." Don't print that headline. Don't run that chyron.

It's a lie. Don't fall for it. https://t.co/FxASmbyzvU

— Nicholas Bagley (@nicholas_bagley) September 24, 2020

Odds of most mainstream media outlets heeding Professor Bagley's warning: Slim.

I'll also note some sick irony here: For three years, the Trump Administration has been pushing hard for increased enrollment in short-term, limited duration policies as the "solution" to full-price ACA policies for unsubsidized individuals, otherwise known as #ShortAssPlans.

The chief benefit of ShortAssPlans is that they have much lower premiums than ACA policies.

The main reason why ShortAssPlans have much lower premiums is because, with some exceptions, they...aren't required to cover pre-existing conditions.

Donald Trump's executive order on this issue won't do a damned thing, but if it did, it would presumably mean that short-term, limited duration policies would be included and would have to start covering pre-existing conditions.

Which would remove most of the premium cost benefit they currently have over ACA policies.

Update: Sure enough...

Trump touts short-term health plans, which don't typically cover preexisting conditions, at the same event where he said he will sign an executive order protecting Americans with preexisting conditions.

— Noam Levey (@NoamLevey) September 24, 2020

UPDATE: Oh, yeah...as long as Trump was spouting utter nonsense yesterday, he also decided to throw in a completely nonexistent "$200 discount card" to 33 million Medicare enrollees:

President Trump vowed on Thursday to send $200 discount cards for prescription drugs to 33 million older Americans, a $6.6 billion election-eve promise with dubious legal authority that he announced as part of a speech billed as presenting a long-awaited health care plan.

Mr. Trump made the announcement before an audience of health professionals in Charlotte, N.C., where he laid out what the White House called the America First health care plan. Though senior administration officials had previewed the speech, they had not mentioned the drug discount cards.

Mr. Trump’s broader plan is short on specifics, and its two core provisions are largely symbolic. The first is an executive order aimed at protecting people with pre-existing conditions — a provision already in the Affordable Care Act, which Mr. Trump is trying to overturn. The second — a push to end surprise medical billing — would require congressional action.

That left the drug discount cards as the major advance in Mr. Trump’s speech. It was not clear where the money for the cards would come from or whether the White House could legally issue them. But they amounted to a gift to a key constituency, offered weeks before Election Day.

I'm completely out of evens to can at this point.