The Detroit Post
Wednesday, 01 December, 2021

Donald Trump Health Care Plan

Earl Hamilton
• Wednesday, 30 December, 2020
• 7 min read

Leading up to the November election, as he works to dismantle the Affordable Care Act, Donald Trump has been promising us that he has a great healthcare plan on the way. Recently, though, voters and reporters have been getting impatient waiting for this mystery plan, especially with a global health pandemic wreaking havoc on the country.

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© Provided by The Mary Sue Donald Trump delivers remarks on his healthcare Trump has now unveiled his plan … sort of. More accurately, he performative signed an executive order that gives the appearance of unveiling a healthcare plan that, in reality, does absolutely nothing at all.

The move comes as the Trump administration tries to overturn Obamacare in the Supreme Court after getting rid of the key enforcement tool of the law, the individual mandate, when Congress eliminated the penalty for not having insurance. President Barack Obama’s plan, formerly known as the Affordable Care Act, already includes a provision that prevents insurers from discriminating against Americans with pre-existing medical conditions.

When asked if the administration had the legal authority to do this via executive order, Health and Human Services Secretary Alex Agar said, “We will work with Congress or otherwise to ensure that they’re protected.” But Trump ’s executive order does not carry the weight of an actual law if the Affordable Care Act is struck down by the Supreme Court.

Healthcare has emerged as a major issue in Trump ’s first term, and in July he signed an executive order reducing the cost of prescription drugs. © Photo by Aaron P. Bernstein/Getty Images Demonstrators hold signs outside the US Capitol on June 26, 2018, in Washington, DC.

Photo by Aaron P. Bernstein/Getty Images For years, Republicans have lambasted Obamacare, and promised that a full replacement for the Affordable Care Act is in the works. Trump's administration has instituted incremental changes to the landmark healthcare law, and zeroed out the universal coverage mandate.

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Biden, if elected, would likely usher in a different set of tweaks to the law: he's floated the ideas of a public option, and more health insurance tax credits available to middle- and upper-class Americans on ACA plans. Ezekiel Emanuel, a health policy expert who was an architect of the original ACA in the Obama administration, is skeptical that any major Republican changes to his legislation are truly in the works.

“They've had 10, almost 11 years now, after passage of the Affordable Care Act to put in place an alternative, and they haven't done it,” Emanuel told Insider. © Provided by Business Insider President Donald Trump departs a rally at Toledo Express Airport in Stanton, Ohio on September 21, 2021.

Manuel NGA/AFP via Getty Images “They would have done that in 2017 if that's what they wanted to do,” Greg Fans, a consulting actuary with Alone Health Partners, and a risk expert who understands the delicate intricacies of the ACA, told Insider. But legal experts (even some who've recently worked for Trump) told Business Insider that it's pretty unlikely the ACA will ever get scrapped entirely, especially because Republicans have had a hard time articulating why, exactly, they want to repeal it all.

And the law, despite public perception, isn't just about insuring the formerly uninsured; the 900-plus page piece of legislation has also touched many other parts of the American healthcare system. It reduced what seniors pay for prescription drugs, and it allowed the government to test healthcare programs that lower costs and improve care.

© Win Manatee/Getty Images President Donald Trump removes his mask upon return to the White House from Walter Reed National Military Medical Center on October 5, 2021 in Washington, DC. Many Democrats lamented the move, arguing it would make the health insurance marketplace more unstable, by taking more healthy people out of the system.

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Similarly, the White House's “America First Healthcare Plan reads more like a laundry list of incremental changes to the ACA to date. © Chip Somodevilla/Getty Images Democratic presidential nominee Joe Biden prepares to leave New Castle, Delaware, before traveling to Grand Rapids, Michigan.

Chip Somodevilla/Getty Images The possibility of a public option (something somewhat like Medicare, but available to all Americans under 65) is one of the biggest differences between his plan and Trump's. The Biden campaign also says it will eliminate the cap on ACA insurance subsidies, so that people making more than 400% of the federal poverty level ($50,000 for a single person) qualify for tax credits.

Another campaign promise from the Biden team: lowering the cap on how much coverage in the ACA marketplace can cost, from 9.86% of a person's income to 8.5%. President Donald Trump, who has long promised a “beautiful” and “phenomenal” healthcare plan, announced a series of largely meaningless actions on Thursday during a speech in North Carolina that effectively served as a campaign event.

The most tangible proposal Trump unveiled was a vow to send $200 prescription drug discount cards to 33 million Medicare beneficiaries “in the coming weeks.” However, the President said the $6.6 billion outlay needed to fund this program would have to come from savings from his “most favored nations” drug pricing proposal, which he announced on Sept. 13, and which experts say would be close to impossible to implement before the November election. The Trump Administration recently tried and failed to convince the pharmaceutical industry to fund a similar plan, according to the New York Times.

It declares that “it is the policy of the United States that people who suffer from pre-existing conditions will be protected,” Health and Human Services Secretary Alex Agar said on a press call with reporters before Trump ’s speech. Healthcare and legal experts noted that it’s unlikely the White House could put in place similar protections for people with pre-existing conditions without passing a law through Congress.

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He told the often-cheering audience on Thursday that he was glad his Administration has been able to keep the ACA’s protections for pre-existing conditions even as Republicans successfully eliminated other provisions, like the so-called individual mandate. They also failed to make good on senior officials’ claims, made on the press call just ahead of Trump ’s speech Thursday, that the President would present an “historic” proposal.

Trump ’s speech, less than six weeks before an election in which he’s trailing former Vice President Joe Biden in most polls, was widely viewed as another attempt to change the national conversation. Trump is particularly lagging behind Biden on most healthcare issues, and surveys show that most Americans still disapprove of the President’s handling of the coronavirus pandemic.

A new survey released by the Commonwealth Fund on Thursday found that the majority of likely voters in 10 battleground states said Biden is more likely to protect insurance coverage for pre-existing conditions. And a poll by the nonpartisan Kaiser Family Foundation this month found that the majority of voters trust Biden over Trump on a variety of healthcare issues, with the President only leading narrowly on prescription drug prices.

His healthcare policies also included a promise to repeal Obamacare.Although he wasn't successful, he has launched many initiatives that have weakened the law considerably. Among his other initiatives: allowing states to impose work requirements on Medicaid recipients and attempts to lower drug prices.

In March and April, Trump signed four stimulus laws that provided a record $2.5 trillion to agencies, businesses, and families dealing with the pandemic. The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 provided $8.3 billion to federal agencies to respond to the pandemic.

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The almost $3.5 billion Families First Coronavirus Response Act increased sick leave, unemployment benefits, and Medicaid funding. The Paycheck Protection Program and Health Care Enhancement Act allocated $483.4 billion for small businesses, hospitals, and testing.

Trump launched Operation Warp Speed, a program intended to develop and distribute safe vaccines and treatments in record time.He used the Defense Product Act to produce 100,000 ventilators. The New England Journal of Medicine said the U.S. didn't adequately test or provide healthcare workers and the public with enough protective equipment.

The Trump administration has taken many steps to weaken the Affordable Care Act (ACA). The Congressional Budget Office estimated 13 million people would drop coverage by 2027 as a result.

As healthy people drop coverage, health insurance companies may only enroll the sickest and costliest to treat, which increases costs for everyone. Twenty states sued the federal government, saying that the TCA elimination of the individual tax penalty has made the rest of the ACA unconstitutional.

Subsidy costs to the federal government would rise by $194 billion between 2017 and 2027, according to the Congressional Budget Office (CBO). Association and short-terms insurance plans cost less but are exempt from state regulations and aren't required to offer the ACA's 10 essential benefits.

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In his first 100 days, President Trump signed an executive order directing agencies to do what they could within the existing law to lift the ACA regulations. States are also now allowed to charge Medicaid recipients premiums, limit the time they can receive benefits, or enforce drug testing.

In2017, Trump announced he wanted to allow Medicare to negotiate lower prescription drug prices with pharmaceutical companies. In May 2018, Trump revealed the “American Patients First” Plan to reform the rebates drug companies pay to pharmacy benefit managers (IBM).

It may require an act of Congress, according to David Henna, CEO of Active RADAR, in an interview for MedCityNews. A 2019 executive order required drugmakers to disclose their prices of certain drugs in TV advertising.

That would allow people to shop for the best value and the competition should drive prices down.Shortly afterward, several pharmaceutical companies won a lawsuit that blocked the order. In 2020, Trump's executive order required health centers to pass any discounts on insulin and epinephrine to their patients.

As of 2020, average monthly basic Medicare Part D premiums are at their lowest levels since 2013. Through participating enhanced Medicare Part D plans, a month's supply of insulin is available for a $35 copay.


As healthy customers leave those plans, the companies will raise prices to remain profitable. While on the campaign trail in 2016, Trump promised he wouldn't touch Medicare, Medicaid, and Social Security.

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