While Congressional Republicans appear far from united on how toproceed with a plan to fully repeal and replace the AffordableCare Act, President Donald Trump wasted no time puttingin place an executive order that could significantlyimpact existing law, potentially unraveling the entire ACA privateinsurance marketplace.

Trump's executive order directed federal agencies to“waive, defer, grant exemptions from, or delay the implementationof any provision or requirement” of the ACA that would “impose afiscal burden” on states, health care providers or individuals.

The order is limited in scope, since much ofthe ACA can only be undone by an act of Congress.However, the directive may very well undo much of the enforcementthat underpins the ACA marketplace, including of the individualmandate to purchase insurance and a variety of mandates onemployers, including the requirement to provide full-time employeeswith coverage or pay a fine.

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