Keenan Briefings


President Trump issues new Executive Order regarding Healthcare

June 27, 2019

On June 24, 2019, President Donald Trump issued an Executive Order on healthcare, entitled, “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.” In the Executive Order, President Trump ordered the departments of Health and Human Services (HHS), Treasury, Labor, Defense, Veterans Affairs, the Office of Personnel Management (OPM), the Attorney General (AG), and the Federal Trade Commission (FTC) to issue reports, guidance and regulations aimed at improving price and quality transparency. This marks the President’s third Executive Order on healthcare.

The document requires regulatory action on the following timeline:

60 days from the Executive Order:

  • HHS must propose a regulation to require hospitals to publicly post standard charge information, including charges and information based on negotiated rates for common or shoppable services, supplies or fees billed by the hospital or provided by hospital employees.

90 days from the Executive Order:

  • HHS, Treasury, and Labor must issue an advance notice of proposed rulemaking soliciting comment on a proposal to require healthcare payers (including self-funded plans) and providers to provide or facilitate access to information about expected out-of-pocket costs for items or services to patients prior to receiving care.

120 days from the Executive Order:

  • Treasury must issue guidance to expand the ability of patients to select high-deductible health plans that can be used alongside a health savings account (HSA).

180 days from the Executive Order:

  • HHS, in consultation with the AG and FTC, must issue a report describing the manners in which the federal government or private sector are impeding healthcare price and quality transparency for patients, and make recommendations for eliminating those impediments.
  • HHS, Defense, and Veterans Affairs must develop a Health Quality Roadmap that aims to align and improve reporting on data and quality measures across government-provided health plans including Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and the military and veterans’ health systems.
  • HHS, in consultation with Treasury, Defense, Labor, Veterans Affairs and OPM, must increase access to de-identified claims data from taxpayer-funded healthcare programs and group health plans for researchers, innovators, providers and entrepreneurs in a way that ensures patient privacy and security. The intent of this part of the Executive Order is to facilitate the development of tools that empower patients to be better informed as they make health care decisions. It also is intended to enable researchers and entrepreneurs to locate inefficiencies and opportunities for improvement.
  • Treasury must propose regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under I.R.C. section 213(d).
  • Treasury must issue guidance to increase the amount of funds that can carry over without penalty at the end of the year for flexible spending arrangements (FSAs).
  • HHS must submit a report to the President on additional steps the Administration may take to address surprise medical billing.


For employer-provided plans, the most notable provisions of the order are those concerning out-of-pocket costs, HSAs, FSAs, and eligible expenses under section 213(d).

We will follow the rulemaking processes outlined in this Executive Order closely in the coming months.

Congress has also addressed attention to transparency and costs, as outlined in our May 28, 2019 Briefing, “Sen. Murray and Alexander Release Draft Legislation: The “Lower Health Care Costs Act.” The Briefing can be accessed on or by this link.

Please contact your Keenan Account Manager for questions regarding this Briefing.

Keenan & Associates is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Clients are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the clients’ business activities.