Trumpcare One new policy wouldlet employers use HRAs to reimburse employees' premiums on theindividual health-insurance market up to $1,800. (Photo:Shutterstock)

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Health care reform could make or break the midterm elections. Perhaps to distract from theblack eye of pre-existing conditions, the Trumpadministration has announced new changes to the ACA aimed at makingthe government health regulation more palatable to employers.

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According to The Hill, the latest policy emanating from theWhite House is one that would change how employers offer insurancecoverage by ending a prohibition on allowing more companies toprovide health reimbursement arrangements—anotherObama-era provision.

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Related: 9 top FAQs about HSAs, FSAs, andHRAs

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The new policy would let employers use HRAs to reimburseemployees' premiums on the individual health-insurance market up to$1,800, and would apply to small- and medium-sized companies notcurrently offering health insurance to workers.

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In addition, new guidance loosened restrictions on statesseeking to waive ACA requirements and put in place “conservativehealth policies that were previously not allowed under the Obamaadministration.” While such coverage would have proved inadequateunder the ACA, the new guidance allows states to adopt plans withfar less comprehensive coverage that would appeal to younger andhealthier people—thus creating a “parallel” insurance market thatcould help to destabilize ACA marketplaces.

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The new guidance, the Hill reports, emphasizes “access” to coverage, rather than thelevel of coverage.

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And while the White House is busy issuing new rules, Democratsare asserting that the Trump administration's actions on waiversthat allow states to avoid ACA requirements prove that Republicans“do not actually want to protect people with pre-existingconditions,” according to The Hill.

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Regulations that make it easier for states to get around ACArequirements guaranteeing coverage for a range of care, as well aspolicies that allow states to use ACA subsidies to buy short-termpolicies that provide considerably less coverage or reject peoplewith preexisting conditions, say Democrats, make it easier forstates to undermine ACA protections.

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Senate Democratic Leader Charles Schumer, NY, said in astatement, “Just weeks before the election, Republicans are onceagain undermining protections for people with preexistingconditions and sabotaging our health care system.” Schumer added,“The American people should look at what Republicans are doing,rather than what they're saying, when it comes to health care.”

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Republicans have very recently changed tack to claim that theysupport preserving care for those with preexisting conditions whilestill supporting measures to roll back not just ACA rules, but theACA itself.

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Republicans claim that the new rules and guidance just makecheaper coverage available in addition to the more costlyACA-compliant policies.

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Marlene Satter

Marlene Y. Satter has worked in and written about the financial industry for decades.