Trump threatens to take Obamacare repeal into his own hands using 'power of the pen'

Congress has repeatedly failed to make good on his promise to repeal and replace Obamacare

President Donald Trump (AP)

With a Republican-controlled Congress unable to pass a healthcare bill, Donald Trump has said he will take matters into his own hands by signing an order – “probably this week” – to allow people to buy stripped-down health insurance policies across state lines.

The action could further undermine Obamacare, otherwise known as the Affordable Care Act, which Republicans in Congress have repeatedly failed to repeal and replace.

While offering few details about the plan, Mr Trump said people will be able to “get great competitive healthcare, and it will cost the United States nothing.”

“With Congress the way it is, I decided to take it upon myself,” Mr Trump told reporters in the Oval Office during a meeting with former Secretary of State Henry Kissinger.

“So we'll be announcing that soon as far as the signing's concerned, but it's largely worked out,” the President added.

White House spokeswoman Sarah Huckabee Sanders said Mr Trump will make his announcement “by the end of Friday.”

The Wall Street Journal previously reported that the President would direct the Labour Department to spur the sale of insurance across state lines through the use of “association health plans”.

The expected order would allow small businesses and individuals to band together as associations to buy health insurance plans that would be exempt from some Obamacare requirements. These include mandatory coverage for 10 essential health benefits such as maternity and newborn care, prescription drugs and mental health treatment.

Republicans have long supported the idea to allow coverage to be sold across state lines, saying this would be the most effective way to promote competition among health insurers – particularly in areas where people buying coverage on their own only have one insurer selling plans.

Meanwhile, Democrats argue that the order could potentially undermine the consumer protections laid out in the ACA.

The association health plans could be sold in a state that doesn't require policies to provide as many benefits as other states. These health insurance policies are anticipated to be cheaper than those that provide the full range of medical coverage required under Obamacare, potentially making them attractive to people across state lines.

But experts have questioned Mr Trump's authority to issue such an order that would exempt some plans but not others from Obamacare rules. By issuing an executive order on the matter instead of pursuing change through legislation, Mr Trump could open up the administration to legal challenges from Democratic state attorneys general.

The stripped-down insurance policies allowed under the order are likely to entice young and healthy people away from the individual insurance markets created by the ACA. That could further destabilise those markets because only the sickest people would likely continue purchasing insurance on the exchanges.

If this happens, experts expect premiums to rise rapidly, effectively eroding the law's protection that people with pre-existing medical conditions cannot be charged more.

Mr Trump's decision to issue an executive order on healthcare is another example of his growing impatience with Congress, particularly the Senate, for not being able to make good on his campaign promise to repeal and replace his predecessor's healthcare law.

But while Republicans in the Senate haven't been able to agree on legislation that would overhaul Obamacare, Mr Trump has already attacked the law through a series or regulatory and administrative measures.

The administration has slashed the ACA advertising budget, halved the open enrollment period and cut funding to groups that help sign people up for insurance under the law.

His expected order this week is viewed by many to be his next action against the ACA.

Mr Trump had hinted earlier on Tuesday that he would sign an executive order on the issue, tweeting: “Since Congress can’t get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people – FAST”.