If President Donald Trump wins reelection next week, it seems unlikely he will unveil the health plan he’s been promising since before his election in 2016. Still, other aspects of health care could be featured in his second-term agenda.
Not having a replacement plan for the Affordable Care Act may be just fine with many of his supporters and conservatives. Most Republicans don’t want the federal government to remake the nation’s health system, said Grace-Marie Turner, of the conservative Galen Institute. “It’s a different philosophy from Democrats, who think it needs to be a big program,” she said. “Conservatives, we think of it in a more targeted way.”
Trump, of course, repeatedly promises something big. “We will have Healthcare which is FAR BETTER than ObamaCare, at a FAR LOWER COST – BIG PREMIUM REDUCTION,” he tweeted Oct. 12 — hardly the first time he’s made a similar promise. “PEOPLE WITH PRE EXISTING CONDITIONS WILL BE PROTECTED AT AN EVEN HIGHER LEVEL THAN NOW. HIGHLY UNPOPULAR AND UNFAIR INDIVIDUAL MANDATE ALREADY TERMINATED. YOU’RE WELCOME!”
But Trump needs a contingency plan if the Supreme Court accepts his argument that the ACA should be overturned. The justices are scheduled to hear the case the week after Election Day. Administration health officials have pledged to have an alternative if the high court does as they ask. But they have refused to publicly share any details.
In September, Trump unveiled a package of health care proposals at a speech in North Carolina. The “America First Healthcare Plan” is less than an actual plan, though. It’s a vague set of claims about things that have not happened yet — like bringing down prescription drug prices — along with a laundry list of some of his administration’s lesser accomplishments on health issues, such as the initiative to help Americans with severe kidney disease and efforts to improve the availability of health care in rural areas.
As part of that overall health plan, Trump issued an executive order declaring “it has been and will continue to be the policy of the United States … to ensure that Americans with pre-existing conditions can obtain the insurance of their choice at affordable rates.” But there is nothing in the order — or in the broader outline — to ensure that would be the case if the ACA were struck down. It would take congressional action to guarantee that.
The current court controversy over the ACA arose because Congress in its 2017 tax bill eliminated the financial penalty for not having health insurance. But Congress didn’t have the votes to get rid of the mandate itself under the rules for the tax bill. Republican state officials then sued, arguing that since the Supreme Court had once upheld the ACA’s mandate, calling it a tax, once the penalty was gone, the law should also be invalidated.
Trump frequently heralds his actions, erroneously saying he killed the mandate and arguing that he got rid of the most detested part of the law.
“He likes to use words, but I don’t think there’s been a substantive policy yet,” said Len Nichols, a health policy professor at George Mason University. “I have no clue what he would do” in a second term “other than trying to repeal the ACA.”
One thing Trump accomplished in his first term is a set of potentially far-reaching regulatory actions, many of which have been challenged in federal courts. Those include allowing states to implement work requirements for people who receive Medicaid health benefits and requiring hospitals and other health providers to make their negotiated prices available to the public.
Legal analysts have doubted the administration’s authority to implement many changes Trump has proposed. But considering Trump has appointed hundreds of federal judges, including Supreme Court justices, the legal landscape may be changing and more of those proposals could be allowed to proceed.
Still, Trump faces uphill battles on some of his preferred health initiatives, even if Republicans control Congress.
For example, said Dan Mendelson of the consulting group Avalere Health, “I would expect that if he’s reelected there would be a drug pricing agenda he continues to push.” Among his proposals is having Medicare pay for drugs based on what the medicines sell for in countries that negotiate prices. That would be complicated, Mendelson said, by the fact that “the broader Republican Party doesn’t want to move to a regulatory model in this country.”
But the Galen Institute’s Turner said not to discount the changes Trump has made, such as allowing broader sales of short-term health plans that are less expensive but offer fewer benefits than ACA plans. She said to expect actions in a similar vein in a second term. “He really has done a lot, using his executive authority, based on trying to make markets work better and give people more choice,” she said. “They are strategic, targeted approaches to specific problems.”
He’ll certainly have a specific problem if the ACA is struck down. Americans losing their insurance won’t want to wait to find out if he has a plan.
–Julie Rovner, Kaiser Health News
Steve Ward says
The tweeter in chief has no plan about anything. He is full of shit. He “Wings It”. Yeah We know. See C19 response. Massive numbers piling up. In a Pandemic looking to eliminate ACA. Hes a stable genius LMAO . He cant manage a lemonade stand. POTUS couldnt find his backside in the dark with both hands.
The clown prince said he’s already got the new plan.. It being rolled out shortly.
Maybe its rounding the corner, rounding the corner.
The same corner his tax returns are rounding.
Smoke and mirrors is not a goof governing style. Most leaders under promise and over achieve; Trump, on the other hand over promises and doesn’t achieve. He has had four years for a Plan to be developed. It could have been shelved until a time like this. You know that there is no Plan in the lifeline because NO Republican candidate for Congress or the Senate has mentioned it on their campaign trail. That, to me, might be a tipping point for the undecided voter. How many people will die until the President has a Plan – Trumpcare. He personalizes all of his real estate why not his healthcare plan. I guess, since it is apparent he does not care about the 225,000+ souls we lost to Covid-19, he will also not care about the poor souls who perish due to his lack of healthcare planning. Remember….every person who has tested Positive for Covid-19, including the President, the First Lady, and the youngest First Son, are now deemed to have pre-existing conditions. That means that about 30 MILLION people will not be able to get healthcare coverage. ALL BECAUSE HE IS JEALOUS OF THE WAY THAT PRESIDENT OBAMA IS HELD IN HIGH REGARD AND RESPECTED BY THE AMERICAN PEOPLE.
CB from PC says
Up until Obama, Jimmie Carter was the worst President in my lifetime.
Obama walked away with a lot of money and did very little for African Americans.
He was some guy to ease the guilt of White Liberals, who only voted for him because “moderate” Biden was on his ticket.
Someone needs to inform me as to how the courts can reverse a law written by congress
Congress writes laws. The senate approves. The president signs it. done
What does the court have to do about it..
No one elects them
And the Supreme Court addresses the constitutionality of the laws passed by the legislative/executive branches. And there my friend is the beauty of our system and its ‘checks and balances’; say what you will, our constitution is one fine document.
In normal times it works beautifully. In a world never envisioned by the writers where one party has become so infatuated with itself that it can deny basic human rights to the people, I shudder to think what might happen.
Now if a constitutional amendment is passed to create the ACA or support Roe v Wade, the court would not have a say in the matter.
CB from PC says
Trump is not going to eliminate ACA coverage without having replacement plan(s) available,
regardless if Supreme Court declares entire ACA null And void.
I lost my self-employed insurance plan when ACA was mandated.
Why? My INDIVIDUAL plan did not include mammograms, pre-natal care and a host of provisions which I did not need.
ACA had a $6350 deductible, was 4 times the monthly cost of my old plan, and not one of my Physicians accepted ACA at the time.
So I paid the penalty of $540 per year at tax time for something I neither wanted or needed.
Another great idea brought by the Democrat Party.
Are the Democrat Legislators requiring themselves to be covered under ACA?
James M. Mejuto says
re: CB from PC . . . Really has anyone seen trump’s plan? The garbage he gave on 60 Minutes
interview with Leslie Stahl was nothing more than executive orders and other crap. So you don’t
think he’s doing away with pre-existing conditions? That’s 20+ million Americans we’re talking
Do you think maybe, you’re old policy was GARBAGE INSURANCE ? Not worth the paper it was
written on !
CB from PC says
Screw 60 minutes and Lesley Stahl.
Trump has stated pre-existing conditions will be covered. Based on everything with Joe Biden, Trump’s statement is more believable than anything out of Biden’s mouth.
Actually my original policy was great.
Low co-pay, deductible for hospitalization. I think Obamacare is not fit for training puppies.
Rich Santomassino says
CB from PC- why don’t you click on the “is more believable” link in your own post. This is HILARIOUS. Everyone please click CBs link- it reveals a lot more truth than CB ever could!
First, you did not lose you old plan because of the ACA. You lost your plan because your carrier decided to end the coverage.
The ACA does not have any deductibles. Likewise it does not list any doctors, labs, clinics or hospitals. The high deductible and lack of physician inclusion you mention were all a part of the plan YOU selected for yourself, not the doing of the ACA. If you had wanted a lower deductible plan, I know for a fact that they were available. If you wanted a specific doc, go to a PPO plan, not the HMO you apparently selected.
The first year the ACA was available (2014) we found PPO plans with premiums from $200 to $1700 per month with deductibles from ZERO to $6,350. With respect to providers, we never had an issue; and with a kidney transplant, I see several specialists. If you were eligible for the additional tax credit, I know people who got their premiums down to almost nothing. We were able to find a plan which balanced our medical costs, premiums and deductibles and did not bust the bank.
Lastly, the Democratic, Republican and Independent federal legislators (and their staff) are required to purchase health coverage through the ACA Exchange in DC unless they are eligible for approved coverage under another plan such as through spousal employment. NONE of the Republican replacement strategies have this requirement and would put the these folks back on the Federal Employees Health Benefits Program which is funded 100% by the taxpayers. So much for reducing the cost of government . . .
If Obama did such a great job and all you Dems loved him what’s so bad with the current health care program now for all you people that loved him and what he had done, now are waiting for trump to change it, don’t worry will get a lot more done when we get the house back! I sure didn’t like Obama but the only difference is between us Republicans and you Democratics is that is Republicans know how to show respect to people without disrespecting the person for everything they have done regardless of there political views. That’s why we have the freedoms we do so vote and stop complaining!! Trump can do anything and everything and all you liberals still wouldn’t be happy. Just a lost cause with all you liberals. Trump 2020 🇺🇸🇺🇸
James M. Mejuto says
re: John: . . . Republican respect??? . . . You mean the Proud Boys, the Confederacy, the neo-nazis, the
KKK’s and the militias who are intimidating early voters, standing there with assault
weapons in full view.
Would you please break down the first sentence into English? It sounds like you are saying the D’s want trump to change the law.
Scooby Snacks says
Obamacare has been a colossal failure. It has holes in coverage throughout the country. Premiums have climbed, plans have been dropped, deductibles have increased and it seems to get worse every year. Biggest lie of all time was Obama – if you like your doctor you can keep your doctor.
Is something better than nothing if its so bad, just asking.
It was never affordable! We paid almost $400 a month for my wife with a $6000 deductible before they paid anything. Thank God for being 65 and Medicare.
Rich Santomassino says
America has the highest healthcare costs in the world. Trumpers rant on and on over socialism but freely accept social security, stimulus checks and Medicare. We seriously as a nation need to improve and protect the health of our citizens. Socialized medicine works well in other countries and no person is left without healthcare.
If the ACA is overturned, then we better hope to God Joe Biden is elected and can attempt to create and get legislative approval of another socialized program for America’s under and uninsured. Is drumpf wins- our healthcare system will take another downward turn that we affect our nation in a horrendous fashion.
Kaiser health, says it all. They made a lot of money off the ACA. And they aren’t that great of a insurer. And that is from experience. The personal type.
Oh I know his plan. It’s called thinning the herd. He has zero care or concern about the general public. Heck he even let his “supporters” freeze last night without transportation back to their vehicles from his super-spreader event. He’s a narcissist that only cares about his bottom line. He doesn’t even like his children, except Ivanka, you know the daughter who if she wasn’t he’d sleep with? The man is a pig and doesn’t care about you. Problem is, cult mentality shapes and controls the weak-minded and they can’t see the truth that is so obvious to the rest of us that aren’t sheep.
TC from FB says
Not having a plan for “insurance” is exactly the point, the government has no business being in the “insurance” industry just like they have no business being in the who can marry who, or the “fair” housing business. None of it is in the Constitution. Nothing the Federal government runs is run well and you want them deciding whether or not you qualify for cutting edge cancer treatment like proton therapy? There’s a reason why so many Canadians and Brits flock to Jax for cancer treatment and it’s not because their socialized medicine is so great. Maybe the government and Demorats should just mind their own business.
Trump/Covid 2020 says
Ask yourself this question. If socialized medicine is such a failure why hasn’t one country that currently uses it abolished it and went to a private health insurance model? Neither is a perfect system but you would rather someone who’s sole existence as a business is to make a profit making your medical decisions? Google medical tourism and see how many Americans are going to foreign countries for medical issues as well.
Why is each and every viable life no longer precious in our country?
This is precisely where the FOX/trump CULT gets their comments. . . here’s the latest from Don Jr.:
FOX: Don Jr. dismisses coronavirus deaths: ‘The number is almost nothing’
Roughly 1,000 Americans died from Covid-19 on the day the president’s son appeared on Fox News to downplay the U.S. death toll.