President Donald Trump shows an executive order on health care that he signed in the Roosevelt Room of the White House, Thursday, in Washington. Dave Ratner, owner of the Springfield-based chain Dave’s Soda and Pet City, is seen second from the left. AP photo

NORTHAMPTON — On Thursday, local business owner Dave Ratner was one of nearly two dozen people standing around President Donald Trump as he signed an executive order on health care. On Friday, Ratner was receiving intense local blowback for that decision.

“I’m just sick,” the owner of the seven-store chain Dave’s Soda and Pet City said, describing the “email after email” he was receiving from customers and local residents angry about his appearance with Trump. His business’s Facebook page was filled with vows to boycott his business. “I’m sick.”

The executive order in question would, among other things, allow small businesses to join together as associations — like the Retailers Association of Massachusetts, for example — to either self-insure or buy large group health care plans across state lines. Ratner said that would “level the playing field for small businesses” like his, which competes against giants like Petco and Amazon. Ratner said he has had to take on increasing health care costs for more than 150 employees.

But critics have taken issue with the executive order, which they say is designed to sabotage the Affordable Care Act. At issue is that those association health plans, according to the executive order, “will allow more small businesses to avoid many of the [Affordable Care Act’s] costly requirements.” Many fear those “costly requirements” mean the Affordable Care Act’s required benefits — things like preventive and obstetric care that, prior to the ACA’s passage, weren’t required parts of all health care plans.

Exactly which regulations those association health care plans would be exempt from is unclear, however, because the secretary of labor will now have to write those guidelines. But politicians, including many in Massachusetts, have already condemned the executive order as a step toward undoing important Obama-era regulations by offering cheap, less comprehensive plans that don’t have to comply with the Affordable Care Act’s rigorous requirements.

“Today’s executive order could return Americans back to the day where holding an insurance card did not guarantee quality, comprehensive health insurance coverage,” U.S. Sen. Ed Markey said in a statement Thursday. Gov. Charlie Baker’s communications director said the administration “has concerns regarding states’ abilities to hold insurance companies accountable when insurers are able to sell across state lines.”

The executive order also came just a day before the Trump administration announced on Friday a halt to critical subsidies paid to insurers, which help keep millions of low-income Americans covered under the Affordable Care Act. That decision has drawn a lawsuit from 19 Democratic attorneys general, including Maura Healey of Massachusetts. Many analysts have viewed Trump’s actions Thursday and Friday as attempts to undermine the Affordable Care Act by destabilizing insurance markets and increasing premiums.

Backlash

The situation has put Ratner, who was invited to the White House to represent the National Retail Federation, at the direct center of the fierce debate over the future of U.S. health care.

“We can’t support you as you support the undoing of the ACA,” read one customer’s review on the company’s Facebook page. “Not worth paying the higher prices for dog and cat food if Dave cannot support basic access to health care,” read a review on the website Yelp.

But Ratner, for his part, said he was only told that the Trump administration would be reversing the association buying guidelines, a position he’s long advocated for. He said he couldn’t turn down a “once-in-a-lifetime opportunity” to be in the same spot where his presidential heroes — Harry Truman, John F. Kennedy and Abraham Lincoln — signed laws, and that he had no idea about the other parts of the executive order.

“I didn’t go for Trump,” he said of his visit. He went, he said, to support a specific policy that would benefit his business.

“The other components were a complete surprise and caught everyone off guard,” he said.

When asked if he understands the concerns that local residents, and possibly employees, may have about losing their health care or receiving a substandard plan, he said his daughter has a pre-existing medical condition, so he’s sympathetic to worries about benefits being cut from health care.

“I don’t know what other employers are doing, I can only tell you what we do. We offer good health insurance,” he said of his business. “No matter what the law is, we will take care of our employees.”

But for many of Ratner’s detractors, it’s more about being seen as complicit with the Trump administration’s agenda than about any one particular policy.

“By doing this, you’re alienating a large portion of your customer base,” Williamsburg resident Tom Adams, who criticized Ratner on Facebook, told the Gazette. “Even if it is a good plan, I wouldn’t go out of my way to associate with the evil that currently exists in the White House.”

Dusty Christensen can be reached at dchristensen@gazettenet.com.