While Congress naps, Trump acts on Obamacare

President Donald Trump issued a sweeping executive order on Thursday that may help lower costs and create more options for many Americans who struggle to find health insurance. At the same time, the order could be another nail in Obamacare's coffin.

Nobody will know for weeks if not months how the order will pan out: Trump's edict depends on federal agencies' regulations to enact it. We hope the rules prompt insurers to offer new policies that attract consumers.

Trump's aim — more competition, more flexibility, less regulation — is to bring back to the ranks of the insured many people who've been priced out of the market. Under Obamacare, insurers have left markets or raised premiums to cover high costs.

Under the order, small businesses and some individuals should be able to band together and buy insurance via what's known as association health plans. Those policies probably would be less comprehensive and rigid — and thus less expensive — than the pricey policies mandated by Obamacare.

The order also aims to expand the availability of short-term insurance policies. Those offer limited benefits for people between jobs or young adults no longer eligible to be covered under their parents' health plans. The Obama administration said those policies couldn't last more than three months; Trump's order extends that to nearly a year. Good.

It may be, as critics charge, that the Trump changes aggravate the flight of some Americans from the Obamacare policies. That is, the forthcoming rules could help lure younger, healthier people into cheaper, less comprehensive plans. That would leave older, sicker people in traditional plans and drive up the costs for them.

But remember, many Americans already face double digit increases in Obamacare premiums this year. As they did last year. And the year before. In Illinois, hundreds of thousands of consumers who buy on the state's exchange will find an average rate increase of 16 percent to 37 percent next year for the lowest-priced plans.

The sobering context for evaluating any new government health care proposal is that a years-long decline has reached a perilous point: These fast-rising premiums and narrowing choices of health providers threaten to capsize Obamacare.

We hope Trump's order will ramp up pressure on Congress to find a more sweeping solution to fix Obamacare. Several GOP efforts to repeal and replace the law this year fizzled, partly because these efforts attracted no Democratic votes.

Any new effort to repair Obamacare should be bipartisan. Against overwhelming evidence to the contrary, we still believe that is possible, and apparently, so does Trump. The president recently reached out to New York Democratic Sen. Chuck Schumer. One option: a bipartisan Obamacare replacement being designed by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash.

Like or loathe Trump's order, it reflects more urgency than Congress has demonstrated. Open enrollment for Obamacare starts Nov. 1. Millions of Americans will face skimpier choices than they had last year. They'll also face higher prices.

Absent a renewed congressional effort, this won't be the last executive order. Trump says he plans to save “the American people from the nightmare of Obamacare.”

If so, we'll evaluate any future orders one by one. Better, though, that members of Congress in both parties just do their jobs.

— Chicago Tribune