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President Trump said the executive order he signed today is just the beginning of the administration's effort to reshape the health care system, and it's clear where that effort is leading: toward a broader market for insurance plans that are less generous and less expensive.

The bottom line: The substance of Trump's executive order is about what we expected, and many of the details will still have to be worked out through regulations. Broadly, though, it would expand access to more loosely regulated insurance options with low premiums, and some experts say those changes could undermine the Affordable Care Act's insurance markets.

What's next: There are still plenty of big outstanding questions about how each of these policies would work, which federal agencies will have to fill in through regulations. (The executive order itself is just a set of marching orders to those agencies.) That's a long process, and insurance companies have already finalized their most of their offerings for 2018, so these changes won't be reflected in actual insurance plans until 2019.

The details: Trump's executive order does three big things:

  • Expand access to association health plans, in which a group of small employers can band together to buy insurance as a collective.
  • Expand access to short-term health plans. These policies don't cover much and don't cost much; today, you can only keep one for three months. Trump will extend that time limit to a year.
  • Expand the use of health reimbursement accounts, which allow employers to set aside tax-free money to help cover their employees' health care costs. Workers will likely be able to tap that money to pay the premiums for a plan in the individual market.

The reviews: Conservatives are thrilled. Sen. Rand Paul, a champion of association health plans, was at the White House for the signing.

But many independent policy analysts are less enthusiastic. They worry that these changes will divert healthy people into cheaper policies outside the ACA's exchanges, leaving those markets with a sicker and more expensive customer base, which would cause premiums to rise.

Go deeper

Huge wildfire reaches edge of Sequoia National Park

A plume of smoke and flames rise into the air as the fire burns towards Moro Rock during the KNP Complex fire in the Sequoia National Park near Three Rivers, California, on Saturday. Photo: Patrick T. Fallon/AFP via Getty Images

Firefighters in Sequoia National Park were working into the night after two wildfires merged to reach the Giant Forest Saturday.

Why it matters: This forest contains over 2,000 giant sequoias, including the General Sherman Tree — considered the world's largest by volume. Park officials wrapped the trees in foil last week as the Paradise and Colony Fires, now known as the KNP Complex Fire, neared. And officials said early Sunday protection efforts appeared to be working.

3 hours ago - World

U.S. drone strike victims' families in Afghanistan seek compensation

A relative of Ezmarai Ahmadi, who was killed by a U.S. drone strike, looks at the wreckage of a vehicle that was damaged in the strike in the Kwaja Burga neighbourhood of Kabul on Saturday. Photo: Hoshang Hashimi AFP via Getty Images

Relatives of 10 Afghans killed by a U.S. drone strike in Kabul last month said Saturday they want to see punishment and compensation over the deaths.

Driving the news: The relatives said it's "good news" that the U.S. had "officially admitted" that "they had attacked innocents" in the Aug. 29 strike that killed Zamarai Ahmadi, an aid worker with a U.S.-based group, and nine family members, but they still need "justice," per AFP.

Miriam Kramer, author of Space
7 hours ago - Science

All-civilian Inspiration4 is back on Earth after flight to space

A side-by-side of the Inspiration4 crew and a shot of their capsule on the way back to Earth. Photo: SpaceX

The all-civilian Inspiration4 crew is back on Earth after their three-day mission in orbit.

The big picture: The launch and landing of this fully amateur, private space crew marks a changing of the guard from spaceflight being a largely government-led venture to being under the purview of private companies.

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