WASHINGTON • President Donald Trump has signed an executive order that clears the way for potentially sweeping changes in health insurance, including sales of cheaper policies with fewer benefits and fewer protections for consumers than those mandated under the Affordable Care Act.

But most of the changes will not come until federal agencies adopt regulations - a process that could take months.

The order yesterday resulted from Mr Trump's frustration with his inability to persuade a Republican-controlled Congress to repeal the Affordable Care Act, popularly known as Obamacare, a pillar of former president Barack Obama's legacy.

The order was Mr Trump's most concrete step to undo the 2010 law since he took office in January after promising voters he would dismantle it.

"The cost of the Obamacare has been so outrageous, it is absolutely destroying everything in its wake," he said at a signing ceremony in the White House.

Supporters of the current health law called the order "sabotage", a way to destroy the Affordable Care Act without winning a majority in Congress.

Mr Trump directed three Cabinet agencies to develop rules that would expand access to less expensive, less comprehensive insurance, including policies that could be sold by trade associations to their members and short-term medical coverage that could be offered by commercial insurers to individuals and families.

Many of the new insurance products could be exempt from requirements of the Affordable Care Act that Republicans say have contributed to sharp increases in premiums but that supporters say have created a baseline of care that has protected consumers from "junk insurance".

Mr Trump's order could eventually make it easier for small businesses to band together and buy insurance through new entities known as association health plans, which could be created by business and professional groups.

A White House official said these health plans "could potentially allow American employers to form groups across state lines" - a goal championed by Mr Trump and many other Republicans.

Critics, who include state insurance commissioners, most of the health insurance industry and mainstream policy specialists, predict that a proliferation of such health plans will have damaging ripple effects: driving up costs for consumers with serious medical conditions and prompting more insurers to flee the law's marketplaces.

Part of Mr Trump's actions, they say, will spark court challenges over their legality.

NYTIMES, REUTERS, WASHINGTON POST