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Donald Trump on Health Care 2

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Alexander- Murray Plan

On October 17, 2017, Senators Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., announced a bipartisan deal to save Obamacare after Trump stopped reimbursing insurers who waived costs for low-income people. The Alexander-Murray deal would have continued the subsidies until 2019. It tried to restore $106 million to promote the health insurance exchanges. Insurers could offer catastrophic plans to those 30 or older. It loosened the requirements for states to receive so-called 1332 waivers. It required insurance policies to cover Obamacare's 10 essential benefits without raising prices for those with pre-existing conditions.

Alexander-Murray was not approved.

Other Trump Efforts to Weaken the ACA 

Trump asked Congress to create a plan to replace Obamacare. Throughout 2017, they proposed many alternatives. None of them could get enough votes to pass.

On September 22, 2017, the Trump administration announced it would close the health insurance exchanges for 12 hours on the first day of open enrollment, November 1, 2017. It would shut down the exchanges from midnight to noon for “maintenance outages” every Sunday of open enrollment except for December 10, 2017.

The Trump administration cut funding and personnel needed to help people enroll. It cut $5 million in advertising. It also posted negative messages about the ACA on YouTube and Twitter. Still, 8.7 million people signed up for coverage in the 39 states on the federal exchange. It was 0.5 million less than in 2016.

The president directed the Internal Revenue Service to allow people to slide by if they don't get insurance. In his first 100 days, President Trump signed an executive order to "ease the burden" of Obamacare. It directed agencies to do what they could within the existing law to lift the ACA regulations. 

How Trump's Actions Affect You

If you're healthy, Trump’s actions could lower your costs. First, you no longer have to pay the penalty under the new tax plan. Second, you could purchase a short-term or association plan that costs less but doesn’t offer all 10 ACA benefits. If you became sick, you might exceed the plan's annual or lifetime limit. Then you'd have to buy Obamacare insurance for a much higher price.

If you have a chronic illness, your costs will rise. You'll have to rely on the ACA plans on the exchanges. As healthy customers leave those plans, the companies will raise prices to remain profitable. In May 2018, Maryland health insurers asked for an average 30 percent increase in premiums for that very reason.

National health care costs will rise at a faster rate than under Obamacare. With the ACA, costs rose around 5 percent a year. In 2014, they increased by 5.3 percent. In 2015, they rose 5.8 percent. In 2007, they rose 6.5 percent. From 2000 to 2004, health care costs rose 7 percent each year. Obamacare helped more people receive low-cost preventive care before they needed high-cost emergency room care. 

Trump's plan could also add to the debt. As insurance costs rise, so will the cost of subsidies. That increases the deficit and debt.
The ACA's expansion brought the health service industry many new customers. It opposes any changes that take customers away. For that reason alone, they oppose some of Trump's plans.

Hospital groups oppose Trumps' plans for specific reasons. They don't want their emergency room costs to increase. They realize that would happen once preventive care under expanded Medicaid is withdrawn.

The health insurance lobby, America's Health Insurance Plans, opposes any reductions to Medicaid financing. The industry would file lawsuits against any plan they don't support. It played a significant role in forming Obamacare. For example, it was responsible for the individual mandate. The insurance companies wouldn't insure those who are sick unless the government mandated that the healthy are also covered.

Trump Promises No Longer in Current Plans

In the past, Trump has mentioned the following two ideas, but they are not in any current plans.

1. Keep existing Medicare and Social Security benefits intact. These benefits are part of the mandatory budget. They were created by prior Acts of Congress and cannot be changed by a president. It would not solve the problem of rising health care costs. 

2. Offer a universal “market-based” plan. Trump originally wanted to provide a range of choices similar to the Federal Employees Health Benefits Program. In 2016, he suggested expanding Medicare. That's what was in Obama's original health care reform plan. Many are opposed to universal coverage, especially if they see it as a sign of socialism. That was one reason for the failure of Hillarycare.

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