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November 18, 2016

"Quick Fixes" to Obamacare Trump Can Make on Day One

  Institute for Policy Innovation

DALLAS - President-elect Donald Trump and most Republicans campaigned on repealing and replacing the Affordable Care Act (ACA) on Day One of a Trump presidency. Failing to fulfill that promise will send a signal to millions of frustrated voters that Republicans cannot be trusted, warns Institute for Policy Innovation (IPI) resident scholar Dr. Merrill Matthews.

Matthews points out that the model for repeal is the “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015,” which passed both the House and Senate and was vetoed by President Obama.

"As the bill’s name indicates, it used the more limited reconciliation process, which only requires 51 votes and avoids a Senate filibuster,” said Matthews. “The bill repealed Obamacare’s subsidies, tax credits and Medicaid expansion beginning in 2018, among other provisions.  An updated version might extend the deadline to 2019, so that those dependent on government help would not be affected immediately, and giving Republicans a year or two to create a replacement bill that provides for a smooth transition to a new system.”

Even so, said Matthews, there are things that President Trump could do quickly to reduce the law’s current problems and give people more affordable options.

  • Issue an executive order prohibiting the IRS from collecting any Obamacare penalties for not having qualified coverage while Congress develops replacement legislation.  If there is no penalty, the mandate is moot; people not receiving subsidies could then buy whatever coverage they want.
  • Quickly nominate a new Department of Health and Human Services secretary.  The ACA vests tremendous discretionary power in the secretary.  If the secretary has power to implement provisions, the secretary has power to “unimplement” those provisions.  
  • Encourage states to seek 1332 wavers allowing state insurance commissioners to “deem” any health insurance policy available in their state as qualified coverage under HHS’s “extended transitional policy.”  As a Treasury official claimed when Obama arbitrarily postponed enforcement of the employer mandate, the president has “longstanding administrative authority to grant transition relief when implementing new legislation like the ACA.”  This change would allow people receiving taxpayer subsidies to apply them toward any available coverage they choose.

“Republicans must repeal Obamacare,” said Matthews. “Crafting a suitable replacement may take some time, but these steps will get the process started while helping a struggling public find affordable coverage.”


The Institute for Policy Innovation (IPI) is an independent, nonprofit public policy organization based in Dallas. IPI resident scholar Merrill Matthews, Ph.D. is available for interview by contacting Erin Humiston at (972) 874-5139, or Copies of Matthews’s “Ten Steps for a Market-Oriented Health Care System” are available at



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