What Will ‘Trumpcare’ Look Like?
The election has come to an end. President-elect Donald Trump has said he would work to replace “Obamacare” ( officially titled the Patient Protection and Affordable Care Act) and some people are concerned about the possibilities and specific details. The truth is, this may not be able to actually repeal the Affordable Care Act without a 60-senator majority. This is fortunate because sources such as the NY Mag note that approximately 22 million low-income people could lose their coverage following a post-repeal transition period of as long as two years.
He could, however, implement changes using a budgetary process called reconciliation. Jack Hoadley, a Georgetown professor of health policy, told NPR that Trump and the Republicans “are probably, practically speaking, talking about leaving the ACA, as is, in place.”
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As to any changes, Trump has yet to post any details regarding his proposals on his campaign “issues” page. Nor does the website have a health care section. In an e-mailed statement, Hope Hicks, a spokeswoman for Trump, recently stated that a detailed plan is “forthcoming,” but did not specify a time-frame.
There have, however, been some general indications concerning his plans in his public statements. Sources on The Hill confirm that these are a few of the aspects we might see covered in the new “Trumpcare” plan:
Across State Lines Insurance
Trump has said more than once that he favors the common Republican concept of allowing health insurance to be sold across state lines. This is believed to create competition between companies which would result in competitive prices. This type of insurance would also reduce the regulation of health insurance. Vice president of the Kaiser Family Foundation, Larry Levitt, who specializes in nonpartisan health analysis, told the press that “Insurers would flock to the states that have minimal regulation.”
Health savings accounts
During a CNN town hall prior to the election, the president-elect pointed out that health savings accounts would be a part of his plan. HSAs give people what is folks in financing call a “tax-preferenced” account in which people can save money to spend on health care. The plan is to pair this with an insurance plan with a high-deductible because these accounts aid in lowering health care spending because people spend their dollars a bit more consciously. Including them in the plan could cut down on the restrictions that currently limit them.
ACA’s Insurance Mandate
Trump, who once liked the ACA’s mandate, listened to his critics and has more recently stated that he favors keeping the ACA’s ban on insurers discriminating against those with preexisting health conditions. Currently, ACA pairs the ban with the mandate because otherwise, people might not buy insurance ‘til they get sick. The catch here is that it’s difficult to ensure coverage to those with pre-existing conditions without things such as the individual mandate or significant government funds to subsidize the market.
During the last debate, he told the audience that he would allow the “individual states” to decide on the question of abortion. As long as Roe v. Wade was not overturned there would be no further issues with that. The Supreme Court has already ruled that targeted restrictions on abortion providers in such states as Mississippi and Texas are unconstitutional.
Trump has also noted, however, that he would sign the Pain-Capable Unborn Child Protection Act into law. This would ban most abortions after 20 weeks. He also favors the Hyde Amendment — a rider which prevents federal monies such as Medicaid from covering the cost of an abortion. This would only affect low-income women who must rely on Medicaid for insurance.
In the past, Trump has praised single-payer healthcare which Republicans are reputed to oppose. More recently he told the press his plan is not going to be a single-payer plan. He added that he would “take care of people.” He concluded that he “will not let people die on the streets.”