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EO 13813Executive OrderTrump 45 · R Quiet signal

Executive Order 13813

Promoting Healthcare Choice and Competition Across the United States

This executive order directs federal agencies to consider regulatory changes expanding access to association health plans, short-term limited-duration insurance, and health reimbursement arrangements as alternatives to ACA-compliant coverage. It also requires biennial reports on barriers to healthcare competition and choice.

Federal Register Open PDF 82 FR 48385

Impact dates

  1. Subsequent HHS biennial reports on regulatory barriers

  2. First HHS report on regulatory barriers to healthcare competition

  3. Labor Secretary consideration of AHP regulations or guidance

  4. Treasury/Labor/HHS consideration of STLDI regulations or guidance

Key directives

  • Secretary of Labor to consider proposing AHP regulations within 60 days
  • Secretaries of Treasury, Labor, HHS to consider proposing STLDI regulations within 60 days
  • Secretaries of Treasury, Labor, HHS to consider proposing HRA regulations within 120 days
  • HHS Secretary to report on regulatory barriers within 180 days and every 2 years thereafter
  • Consider expanding commonality-of-interest requirements for AHPs
  • Consider allowing STLDI to cover longer periods and be renewable
  • Consider allowing HRAs to be used with nongroup coverage

Who is ordered

Timeline

Immediate

  • EO establishes policy prioritizing AHPs, STLDI, and HRAs
  • Directs agencies to begin considering regulatory changes

Near term (90d)

  • Labor Secretary consideration of AHP regulations (60 days)
  • Treasury/Labor/HHS consideration of STLDI regulations (60 days)
  • Treasury/Labor/HHS consideration of HRA regulations (120 days)

Long term

  • First HHS report on regulatory barriers due (180 days)
  • Biennial reports every 2 years thereafter
  • Potential structural shift in insurance markets if regulations finalized

Risks & tensions

  • All regulatory actions are prefaced with 'consider proposing' and 'to the extent permitted by law,' creating uncertainty about actual implementation
  • Expansion of non-ACA-compliant plans risks market segmentation and adverse selection in ACA exchanges
  • STLDI expansion could leave consumers with inadequate coverage for pre-existing conditions
  • AHP interstate sale raises state regulatory authority tensions
  • Biennial reporting requirement may outlast administration; long-term institutional footprint uncertain
Executive Order 13813: Promoting Healthcare Choice and Competition Across the United States · Executive Orders