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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

Kendall Baker, author of Sports
Updated 13 mins ago - Sports

Tiger Woods crash: What we know

Photo: Wally Skalij/Los Angeles Times via Getty Images

Tiger Woods underwent emergency surgery to repair damage to his right leg and ankle, after he was involved in a single-vehicle accident on Tuesday in which his SUV ran off the road.

What we know: The golf star "is currently awake, responsive and recovering in his hospital room" at Harbor-UCLA Medical Center, according to a late-night statement from his team.

Dan Primack, author of Pro Rata
15 mins ago - Podcasts

Corporate America pressures Congress to act on stimulus

Big corporations and top CEOs are putting pressure on Congress and the White House to pass economic stimulus measures, as the political debate drags on.

Axios Re:Cap goes deeper with Heather Higginbottom, a former Obama administration official and president of the JPMorgan Chase Policy Center, about why her organization just published its first-ever set of policy recommendations.

Capitol repairs, security top $30M since Jan. 6 attacks

Photo: Bill Clark/CQ-Roll Call, Inc via Getty Images

The Architect of the Capitol Brett Blanton on Wednesday said that repairs and security expenses related to the Jan. 6 insurrection have already cost more than $30 million.

The state of play: Congressional appropriations committees have allocated the $30 million for repairs and perimeter fencing around the Capitol building through March 31, per NPR.

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