by Zachary Tracer, November 11, 2016
President-elect Donald Trump outlined some pieces of his health-care program, largely following ideas he laid out during his campaign, from a repeal of Obamacare, his predecessor’s signature health law, to language indicating opposition to abortion.
The brief, 310-word plan gives few details about how Trump will replace the Affordable Care Act, or ACA, except that it would include health savings accounts, and an ability for insurers to sell coverage across state lines.
The document, posted Thursday on the presidential transition website, is the first look at Trump’s plan since the election. It includes protecting “innocent human life from conception to natural death” and gives states a big role in regulating health insurance and in running their Medicaid health-insurance programs for the poor.
“The Administration recognizes that the problems with the U.S. health-care system did not begin with — and will not end with the repeal of — the ACA,” according to the website.
Repealing ACA
The document is similar to a March blueprint from the Republican president-elect’s campaign that endorsed a series of broad ideas popular on the right, including allowing insurers to sell plans across state lines, sending Medicaid funds as block grants to states and making tax-free health savings account part of an estate.
On his transition page Thursday, Trump hinted at softening the coverage guarantee for those with pre-existing conditions under the ACA, saying high-risk pools — state insurance programs for individuals who are sick or otherwise unable to get coverage — would cover those with large medical expenses who have “not maintained continuous coverage.” Repealing the ACA, a law passed in 2010 that brought insurance to about 20 million people who previously lacked it, could leave those with pre-existing conditions without insurance.
The plan doesn’t address the rising cost of prescription drugs, which has been under intensifying scrutiny in the past year in the U.S., nor the possibility of re-importing safe, cheaper medicines from abroad, which was one measure he’d called for in the past.
FDA Reform
The document also doesn’t say whether Trump would retain some of the Affordable Care Act’s more popular provisions, including a rule allowing children to stay on their parents’ plans to age 26.
Trump is calling for a reform of the Food and Drug Administration “to put greater focus on the need of patients for new and innovative medical products,” and says he will “modernize” Medicare, the U.S. health program for the elderly.
During his bid for the Republican nomination, Trump campaigned for stretches at a time without mentioning the ACA, and was vague about his approach. “Repeal and replace with something terrific,” he said in July 2015. “I want to take care of everybody,” he said at the time.
His attacks intensified toward the end of the general election amid news of rising premiums on the exchanges. At his final rally on the eve of the election in Grand Rapids, Michigan, he called for “repealing and replacing the disaster known as Obamacare.”
“With Obamacare, premiums are surging, companies are leaving, insurers are fleeing, doctors are quitting and deductibles are going right through the roof,” he said. A Hillary Clinton presidency, he warned, would “destroy American health care forever.”
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