President Trump signed an Executive Order yesterday that enables the sale of health insurance across state lines. This is designed to expand choice in purchasing health insurance at a time when many of the state-run and federal insurance exchanges have only one insurer and rates are increasing dramatically.

The Executive Order also allows individuals to form associations to negotiate more favorable terms from insurers. This is designed to benefit small businesses, professional groups, the trades, and other cohorts of individuals.

Each of these is designed to expand choice outside of the parameters of the ACA in the hope of making available lower cost health care to millions of Americans. Senator Rand Paul was instrumental in getting this done with the goal of expanding access to more affordable heath care.

Aside from the politics of whether to repair the ACA or jettison it and replace it with market-driven solutions, do these two changes increase affordability and access to health care?

The initial answer has to be yes, however it will take time to see if insurers take advantage of these changes or if smaller regional insurers expand their operations into other states.

The good news about this is its ability to give individuals more self-empowerment while enabling insurers to employ actuarial science based on risk. Hospital providers should benefit since this Executive Order restores choice to many individuals while shifting risk to insurers where it belongs.

Creating a special subset with adequate funding for those with pre-existing medical conditions may be part of an eventual fix for the ACA, but reality says that will have to wait until after the mid-term elections for Congress.

In addition, it is important to note that the Big Four insurers are well into negotiations to merge with retail giants, therefore the potential of President Trump’s Executive Order to disrupt the insurance market remains in question.