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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

Golfer Bryson DeChambeau will miss Olympics after testing positive for COVID

Bryson DeChambeau of the United States on the 18th tee during Day Two of the 149th Open at Royal St George’s Golf Club on July 16 in Sandwich, England. Photo: Andrew Redington/Getty Images

Golfer Bryson DeChambeau has tested positive for COVID-19 and will miss the Tokyo Olympic Games, USA Golf announced late Saturday.

What's happening: "Patrick Reed will replace DeChambeau and is undergoing the requisite testing protocol" Sunday and Monday before his expected departure for Japan, per a USA Golf statement.

In photos: Scenes from some of the worst fires raging in the U.S.

A home explodes into flames as the Dixie Fire rips through the Indian Falls neighborhood of unincorporated Plumas County, California, on July 24. The blaze started near the origin of the deadly 2018 Camp Fire and has churned burned over 185,000 acres. Photo: Josh Edelson/AFP via Getty Images

Out-of-state crews went to Montana to tackle a wildfire that wounded five firefighters as Australia sent a large air tanker to help Californian firefighting efforts, as 88 large blazes raged in the U.S. Saturday.

The big picture: Montana Gov. Greg Gianforte (R) tweeted his thanks to Utah and California for sending crews over the weekend, as the two states battle their own blazes. The Australian tanker arrived in Calif., this week, where Gov. Gavin Newsom (D) proclaimed a state of emergency for four northern counties Friday.

Updated 4 hours ago - Sports

Swimmer Chase Kalisz first American to win Tokyo Olympics gold medal

Chase Kalisz of Team United States celebrates after winning the Men's 400m Individual Medley Final on day two of the Tokyo 2020 Olympic Games at Tokyo Aquatics Centre in Tokyo, Japan. Photo: Al Bello/Getty Images

Swimmer Chase Kalisz has become the first Team United States Olympian to win gold at the Tokyo Games.

The big picture: The Rio 2016 silver medalist's winning time in the men's 400 meters Individual Medley Final was 4 minutes 9.42 seconds. His teammate Jay Litherland took silver, .86 seconds behind him. Moments later, Kieran Smith grabbed a third medal for the U.S. when he won bronze in the 400-meter freestyle.

Go deeper: Full Axios coverage

Editor's note: This article has been updated with new details throughout.

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