As he has developed a replacement package, Trump said he has paid attention to critics who say that repealing Obamacare would put coverage at risk for more than 20 million Americans covered under the law’s insurance exchanges and Medicaid expansion. “We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.” Republican leaders have said that they will not strand people who gained insurance under the ACA without coverage. But it remains unclear from either Trump’s comments in the interview or recent remarks by GOP leaders on Capitol Hill how they intend to accomplish that.
Trump also said that he doesn’t want “single-payer” health care. “What I do want is to be able to take care of people,” he told the Post. During the first Republican primary debate, Trump was pressed on his past praise for single-payer systems. The candidate reiterated his view that government-run health care “works” in places where it is implemented.
“As far as single payer, it works in Canada,” Trump said in August 2015. “It works incredibly well in Scotland. It could have worked in a different age, which is the age you’re talking about here.”
That view of what works in health care is at odds with what the majority of Republicans on Capitol Hill have embraced since the passage of Obamacare in 2010. Trump’s selection for Secretary of Health and Human Services, Georgia congressman Tom Price, has put forth his own plan that uses free-market reforms and tax credits in an effort to give consumers more control and more choice over their health insurance. Price and other Republican health-care reformers have shied away from promising universal insurance coverage, but the rhetoric coming from Trump and his advisers since the election have contradicted this.
At the Washington Examiner, Philip Klein has written about the pitfalls of overpromising on health-care reform:
“We don’t want anyone who currently has insurance to not have insurance,” said senior Trump adviser Kellyanne Conway about those who are currently covered through Obamacare. There is simply no way that Republicans could repeal the taxes, regulations and spending in Obamacare and expect that it won’t cause any disruption to anybody. Though it’s true that, in theory, Republicans could cover as many people as Obamacare for less money if they moved toward a system of catastrophic coverage (that is, toward plans aimed at protecting people against financial ruin in the case of a major illnesses or accidents), Trump’s own boasts make that more difficult. Trump has attacked Obamacare for having high premiums while “deductibles are so high that it is practically useless.” This even though any plan to tackle premiums would hinge on reducing regulations so that individuals would have the option of purchasing cheaper plans that carry higher deductibles. Republicans are in serious danger of repeating Obama’s mistake, because they are having a tough time stating a simple truth, which goes something like this: “We don’t believe that it is the job of the federal government to guarantee that everybody has health insurance.”
Read the whole thing here.
