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On the day of his inauguration, President Trump signed an executive order instructing the executive branch agencies to exercise their discretion and authority to "waive, defer, grant exemptions from, or delay the implementation of" fees, taxes, or penalties under the Affordable Care Act (ACA).
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For example, the implementation of fee exemption policies in particular have led to a decrease in OOP payments for maternal health services [8 12].
This would be breaking a tacit rule of the game, that can be even be observed sometimes in the press: while Malian journalists ignore the difficulties associated with the implementation of fee exemption at the point of service delivery, their editors refer to it in private discussions [ 12].
Stanton et al. reviewed literature on user fees and pointed out the need to further investigate the factors and practices causing patient expenses before institutional implementation of user fees.
It also delays the implementation of these fees by one year, until 2011, and makes changes to facilitate administration by the IRS.
"When banks announce the implementation of new fees, public reaction can be quite volatile and result in customers voting with their feet," said Michael Beird, director of the banking services practice at J.D. Power and Associates.
An experiment in Germany for instance, has provided positive evidence for implementation of cooperation fees [ 19].
Implementation of such fees at private HFs was viewed to contribute to poor IPTp adherence.
In Niger, the team consisted of four people from departments of the Ministry of Health and three members of NGOs involved in supporting the implementation of user fees exemption policies.
This transversal analysis confirms the need to assign a great deal of importance to the implementation of user fees exemption policies once these decisions have been taken.
For example, the implementation of user fees failed to achieve consistent positive impacts in many sub-Saharan African countries compared to countries in other regions.
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