Critics of Republican front-runner Donald Trump have said his plans to “Make America Great Again” are scant on details, but on Wednesday night he got specific about what he would do to reform health care.
The proposals go further than promising to save people from “dying in the streets” – a phrase he has repeated often in the debates.
On his website, he detailed his seven-point plan, which he says will broaden access, increase affordability, and improve quality. Like other Republicans, candidate Trump has consistently vowed to “repeal Obamacare,” President Barack Obama’s signature health care law, but in his proposal he acknowledged that such a move would require an act of Congress.
“On day one of the Trump administration, we will ask Congress to immediately deliver a full repeal of Obamacare,” says the proposal. Members of Congress have tried to repeal the law more than 50 times, but this January for the first time they managed to send a bill to Obama’s desk, which he promptly vetoed. Though the move was expected, Republicans were sending a message to voters that if they put a Republican in the White House – and maintain their majority in Congress – then Obama’ s health care law would no longer stand.
Obamacare has several provisions written in the roughly 1,000-page law that aim to increase access to health coverage and improve the quality of care. Trump specifically said that Congress should repeal the “individual mandate,” the portion of the law that requires all Americans to get health insurance or pay a tax penalty. This point represents a shift from his apparent position in a CNN town hall in February, in which Trump said he liked the mandate.
“No person should be required to buy insurance unless he or she wants to,” he said on his website. He proposed allowing people to deduct health insurance premiums from their taxes, and to sign up for tax-free Health Savings Accounts, which are meant to accumulate to cover medical expenses, and have high deductibles.
Under Obamacare, low- and middle-income people receive tax subsidies to help them pay for coverage. Consumers have complained that some of the plans come with high deductibles, which are aimed to encourage people to seek out care only when they need it, and to shop for medical care to find the best deals. High-deductible plans are endorsed by economists, but in the real world they have played out differently than anticipated: rather than shop for cheaper care, many patients forego it altogether.
Echoing the importance of consumer choice in reducing the cost of care, Trump said that under his plan, doctors, clinics and hospitals would make it easier for consumers to compare prices of different procedures or exams. He did not specify, however, where and how the prices would be listed.
Trump also proposed allowing states to sell insurance across state lines. Though touted by other Republican candidates – including Sens. Ted Cruz of Texas and Marco Rubio of Florida – the provision is already in the Affordable Care Act, but the Obama administration has not implemented it and has not announced when it would do so.
One of the most contested parts of Obamacare has been a provision that obligates states to expand Medicaid, the government’s program for low-income Americans. Even the Supreme Court ruled that states could choose whether they wanted to implement the program, and so far the District of Columbia and 31 states have done so – the rest say they are concerned about costs.
Under Trumps’ plan, the government would provide block grants to states so they could manage what they want Medicaid to include, rather than Obamacare’s guarantee that people under a specific income receive coverage. Improving the economy, Trump wrote, would lessen the country’s reliance on Medicaid. Currently, the program, along with the Children’s Health Insurance Program, covers 72.5 million Americans, 14.5 million of which were added under the Obamacare provision.
On prescription drugs, Trump said he would allow Americans to buy medicines in other countries. In the past he has publicly said that he would allow Medicare to negotiate drug prices, but did not reiterate this plan in Wednesday’s post.
He said “promising reforms” were being developed on mental health, and though he didn’t specify which bill he was referring to, he mentioned that current privacy laws make it difficult for families to get information about their loved ones. A mental health bill introduced in the House, by Rep. Tim Murphy, R-Pa., specifically addresses the privacy issues families face. This very provision, however, have been flagged by critics of the bill.
Trump also brought up the cost of caring for illegal immigrants, which he says is costing the country $11 billion a year. He did not say where the figure came from, but wrote that strengthening immigration laws would reduce these costs.
Copyright 2016 U.S. News & World Report
Written by Kimberly Leonard of U.S. News & World Report
(Source: U.S. News & World Report)