The Trump administration has made radical changes in the health care system by stretching the limits of executive authority—much more so than Barack Obama did.

Although these changes have been largely ignored by the mainstream media and even the health care media, they have the potential to transform the health care system without any real revision of Obamacare. Two changes are particularly important.

The first change occurred last month. Employers can now make pre-tax dollars available to their employees to buy their own health insurance.

In an ideal world, most people would own their own health insurance and take it with them as they traveled from job to job and in and out of the labor market. Some employers may have better insurance than is available on the open market. But many would like to get out of the health insurance business altogether and make a cash contribution to help employees buy their own.

Some employers were actually doing that before Obamacare. They used an account called a Health Reimbursement Arrangement (HRA), providing tax-free funds employees could use to buy their own health insurance.But the Obama administration effectively deep-sixed this option by threatening to fine any employer caught in the act by as much as $100 per employee per day, or $36,000 per year. That was the highest fine imposed under Obamacare.