As President Donald Trump signed an executive order on Thursday that he said would provide "relief" from the Affordable Care Act, a Massachusetts shop owner stood over his shoulder.
Dave Ratner, the owner of the Springfield-based, seven-store chain Dave's Soda and Pet City and a board member of the Retailers Association of Massachusetts, was among the small business owners and association heads invited to the White House for what Trump called a "historic" announcement.
Among other initiatives, the order directs Labor Secretary Alexander Acosta to consider ways to expand access to "association health plans" and potentially allow employers to form such groups across state lines, which Trump said would let more small businesses buy affordable and competitive health insurance.
Association health plans allow small businesses and individuals to pool together and buy insurance through a group or organization.
"This will create tremendous competition and transformative, in so many ways, change aimed at creating more and lower prices for millions of Americans," Trump said. "But the competition will be staggering. Insurance companies will be fighting to get every single person signed up, and you will be hopefully negotiating, negotiating, negotiating, and you'll get such low prices for such great care. Should have been done a long time ago, and it could have been done a long time ago."
Jon Hurst, president of the retailers of Massachusetts, said the association health plans component of the order came as a surprise.
"But it certainly is very welcome, because, look, this is how small businesses want to buy their insurance, and frankly, government, whether it's state governments or federal governments, shouldn't be discriminating between business with 50 employees and one with 51," Hurst said.
Hurst said association health plans would give small businesses "buying clout" and put them on more even footing with the larger companies they compete against for both customers and employees.
Trump's order begins, "It shall be the policy of the executive branch, to the extent consistent with law, to facilitate the purchase of insurance across State lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people."
Attorney General Maura Healey previously told the News Service she worried about the potential for an executive order on interstate sales that could "open the floodgates and allow a bunch of bad plans to come in and market to our residents here, particularly when we've got some terrific health plans doing business here."
Lizzy Guyton, communications director for Gov. Charlie Baker, said Thursday that his administration is "reviewing the executive order and has concerns regarding states' abilities to hold insurance companies accountable when insurers are able to sell across state lines."
The order comes after multiple unsuccessful attempts to legislatively repeal President Barack Obama's signature health care law, known as the Affordable Care Act. It targets three areas where the Trump Administration said the current law limits choice -- the association health plans, short-term, limited-duration insurance, and health reimbursement arrangements.
The short-term insurance, according to the order, is exempt from mandates and regulations included in the Affordable Care Act. The order directs members of Trump's Cabinet to consider allowing such insurance -- which can now run less than three months -- to cover longer periods and be eligible for renewal.
Health reimbursement arrangements are benefit plans where an employer puts aside a set amount of money to reimburse employees for out-of-pocket medical costs and their individual health insurance premiums.
Sen. Ed Markey said in a statement that Trump's order would allow the purchase of health plans that do not comply with the Affordable Care Act's consumer protection standards.
"Instead of creating certainty for American families, President Trump’s executive order will create chaos by sabotaging our health care system and increase costs for millions of Americans," Markey said. "Today's executive order could return Americans back to the day where holding an insurance card did not guarantee quality, comprehensive health insurance coverage. These incessant attempts by the President and Congressional Republicans to undermine the health insurance market only undermine bipartisan discussions to improve the Affordable Care Act and reduce health care costs, something Americans have made clear they support."
U.S. Rep. Joseph Kennedy said Trump "has obliterated the promise of protection for preexisting conditions and the guarantee of essential health benefits for millions of Americans."
This report was originally published by the State House News Service.