President
Donald Trump is calling for members of both parties in Congress to support his
ideas to replace the Affordable Care Act.
In a speech before Congress Tuesday night, Trump outlined, for the first time,
a more detailed healthcare reform package.
First, he wants people with pre-existing conditions to maintain coverage. Trump
suggested Americans buy their own plans with tax credits and expanded health
savings accounts.
It's unlikely Democrats will back many of Trump's suggestions. While
Republicans stood and applauded during the evening address, their colleagues
across the aisle largely remained seated and stone-faced.
Trump pushed back against stabilizing the individual market before addressing
Medicaid expansion. GOP plans appear to favor a Medicaid program that offers
capped federal funding.
On Tuesday, Trump seemed to indicate the two reforms should occur concurrently.
Earlier this week, Trump met with insurers who said they were encouraged by
recent moves by Trump's administration to address some of the industry's
concerns.
In what appeared to be a nod to governors who also met with the president this
week, Trump called on Congress to give states resources and flexibility to
tweak Medicaid as governors see fit.
Finally, he returned to his campaign idea of allowing insurance be sold across
state lines.
"Mandating every American to buy government-approved health insurance was
never the right solution for America. The way to make health insurance available
to everyone is to lower the cost of health insurance, and that is what we will
do," he said.
His ideas reflect what other Republicans have included in plans circulated over
the past year, though no one plan appears to have broad support.
Policy experts have decried many of the ideas, such as a greater reliance on
health savings accounts instead of premium subsidies.
HSAs fail to benefit low-income people who might not have extra cash to store
away for healthcare, according to the Center for American Progress. “This
proposal would replace assistance for low-income people with a tax shelter for
the wealthy,” the left-leaning think tank said.
HSAs are generally tied to high-deductible health plans, meaning that
individuals might be responsible for higher out of pocket costs.
Some conservative lawmakers say tax credits and HSAs amount to "Obamacare
lite."
Former Kentucky Gov. Steve Beshear, who expanded Medicaid while in office,
delivered the Democrats' response to the speech. Kentucky saw some of the biggest
drops in the uninsured rate as a result of the expansion.
He gave voice to concerns Trump's ideas would result in more uninsured people.
"You and your Republican allies in Congress seem determined to rip
affordable health insurance away from millions of Americans who most need
it," Beshear said.
Still, he said he hoped Trump could be successful in providing more and better
healthcare.
“Keep your word. This isn't a game,” Beshear said, addressing Trump. “It's life
and death for people.”
The American Academy of Family Physicians expressed dismay over Trump's ideas.
"He has stepped back from policies that will ensure all Americans have
access to meaningful, affordable health care coverage,” Dr. John Megis.
Trump's plan “to slash premium subsidies for hard-working families would cause
many millions to lose health coverage,” said Ron Pollack, executive director of
the advocacy group Families USA. "It would also make out-of-pocket costs
unaffordable for many others.”
