Newly unveiled document outlines Trump administration's plan to chip away at the ACA

A document, used at a March meeting between then-HHS Secretary Tom Price and members of Congress, spells out how the Trump administration planned to unwind the ACA through executive actions. (Image: Sarah Stierch/CC BY 4.0)

The Trump administration, it turns out, has had a plan all along for how to unravel the Affordable Care Act without help from Congress.

That plan is enumerated in a one-page document that Sen. Bob Casey, D-Pa., shared with Politico after obtaining it from the administration last month.

The document, which was used at a March 23 meeting between then-Health and Human Services Secretary Tom Price and members of the House, lists 10 potential administrative actions that could “improve the individual and small-group markets most harmed by Obamacare.”

RELATED: New CMS guidance paves way for states to test Medicaid work requirements

The administration has already executed some of the actions listed, such as shortening the open enrollment period for ACA marketplace plans, and it has proposed rules that would implement others, like giving states more authority to define essential health benefits.

Still others, such as encouraging states to build “skinny exchanges” that cost less and rely more heavily on "private sector innovation," do not appear to have made it into any federal proposals or rulemaking yet.

To Casey, the document reveals “a closed-door, back-room slimy deal” aimed at sabotaging the healthcare law, according to Politico.

But while Congress’ attempts to repeal the ACA have indeed grabbed more headlines, President Donald Trump has also publicly touted the fact that he wants to use regulatory action to chip away at the law. In fact, he tweeted in October that since Congress “can’t get its act together” on healthcare, he will use the “power of the pen” to further his policy goals.

He then made good on that promise with an executive order that directs federal agencies to expand the use of association health plans, short-term health plans and health reimbursement arrangements—moves experts said could destabilize the individual insurance markets. This month, the Department of Labor issued the first proposal that would carry out Trump’s order, as it pertains to association health plans.