How A Republican Led Repeal Of Obamacare Without Having A Replacement Plan Ready Will Harm All Americans
Current support for an outright repeal of the Affordable Care Act, also know as Obamacare, led by the Republican controlled Senate is almost unanimous. Just five Republican members of the Senate, are thought to be objecting to an immediate repeal of Obamacare that does not include a replacement.
– Senator Bob Corker of Tennessee
– Senator Rob Portman of Ohio
– Senator Susan Collins of Maine
– Senator Bill Cassidy of Louisiana
– Senator Lisa Murkowski of Alaska
Presently if an outright repeal were to be brought forth and put into action immediately, it would mean that approximately 20 million Americans would be at risk of losing their health coverage very soon. This would also mean that all Americans, not just those insured through Obamacare, but also through an employer, would lose the rights and protections the law affords them as well. So, in effect, a full repeal impacts anyone who has almost any level or type of healthcare coverage, subsidized or not.
Specifically, the most important parts of the law that are universally popular and thought to be a proposed part of President-elect Trump’s replacement plan are the following.
- Guaranteed Issue (You can not be refused coverage because of a pre-existing condition)
- Expanded Age Limit For Children On Parents Policy (Children can remain on a parents policy until they are the age of 26)
- Expansion Of CHIP (More than 9 million children are now receiving insurance benefits because of an expansion of the Children’s Health Insurance Program
- Medicaid Expansion (Medicaid has been expanded in a number of states because of provisions within the Affordable Care Act)
Timeline For Government And Insurance Carriers To Create A Full Replacement
Current timeline estimates for a functional repeal and replace, one that the government and the health insurance carriers work hand-in-hand to craft and then implement is thought to be minimally two years.
Why is this? Well the main reason is simply this, the health insurance industry moves at a glacial pace. This isn’t out of complacency or disinterest in making swift progress to improve outcomes for Americans. No, it is simply a by-product of a large, unwieldy beast of an industry, one that is a touch point in hundreds of millions of Americans lives. This naturally comes with a lot of responsibility and expectation to get it right. Out of necessity, health insurance carriers are data-driven, number crunching, accountants, hunched over complex spreadsheets for months, calculating risk modeling. Their goal is to determine a hopefully accurate estimate on risk exposure and viability of the plans being offered to consumers.
Combine what’s mentioned above with the logistics required to negotiate all new contracts with hospitals, doctors, PBM’s (prescription drugs) urgent care centers, and every other part of the health insurance food chain. When you take into account all of the different moving parts, it is actually easy to understand why a two year minimum for a realistic timeline is not just reasonable, but maybe even be a little optimistic.
What An Outright Repeal Would Mean Immediately
It would mean that the more than 20 million Americans, who currently have coverage under the Affordable Care Act, would be in jeopardy of coverage disruption or losing access to their current available health plan entirely.
Why is this? Well for one, if a repeal is put into action without a replacement — in effect a safety net for those who might be dropped from their coverage if their insurance carrier decides to no longer offer plans with the same minimum benefits — Americans will be harmed.
Insurance carriers would be able to go back to excluding anyone with a pre-existing condition they determined to be too risky from obtaining coverage. Or, if they are offered coverage, their policy might stipulate that any costs associated with treatment for the pre-existing condition would not be covered by their plan.
What are common health conditions that prevented someone from obtaining coverage before the ACA?
- Cancer (all types)
- Extensive Sports Injuries (ACL,MCL and similar injuries)
- Opioid Addiction
- Heart Disease
- Obesity (significantly over weight)
Will President-elect Trump’s Final Obamacare Replacement Plan Be Harmed By A Quick Repeal?
Another aspect that could be troubling for the future success of President-elect Trump’s replacement plan to Obamacare, is that it could make insurance carriers less willing to participate with Obamacare’s replacement in the future. Again, insurance carriers are not unlike massive Navy aircraft carriers that take a considerable amount of time to simply point in another direction, it takes time to move the ship safely in a new direction. For Republicans to not take into consideration what negative impact a fast repeal with no replacement will have on them will not be forgotten.
Presidential elections are held far more often than the health insurance industry wants to plan and rollout the next iteration of healthcare reform. It might be more difficult for President-elect Trump to get buy-in from a majority of health insurance carriers, which is going to be essential in order to have a highly competitive marketplace where costs get driven down because of lots of competition. Making the transition from Obamacare, to President-elect Trump’s replacement for it significantly more difficult. This not only seems to potentially put much of the Senate at odds with the President-elect, but with the voters who elected him in the first place. Many of whom it goes without saying, but we’re saying it anyway, benefitted from the down-ballot vote, or so the Republican-led sweep would leave a reasonable person to believe.
Is The Republican Senate Simply More Interested In Seeking A Swift “Symbolic Repeal” Or To Best Serve Americans?
You kind of have to wonder exactly who benefits from a full repeal that is not paired with a simultaneous replacement ready to go.
- Americans currently covered by Obamacare? No, it certainly doesn’t benefit them. They may no longer have coverage. Obviously anyone who is now recovering from any significant illness or disease would now be in great peril. Impacting a larger percentage of people will be those who simply lose their coverage.
- Americans who have coverage outside of Obamacare through an employer? No, they have more protections now and essential minimum requirements as a result of the ACA.
- Insurance Carriers? No, quick-sweeping legislative changes that throw a wrench into the gears of the healthcare machine they’ve been trying to keep on the road simply forces a lot of carriers to scramble to prevent a sudden crash and or death spiral of the system that is in place.
- Health Insurance Costs, Will Those Go Down? Nope, pricing under any new model will take that same approximate two-year timeline to formulate and negotiate if we’re talking about major medical coverage. Insurance that includes all of the universally popular parts of Obamacare that Trump has said he wants to keep.
- Wealthy People? Yes, it is entirely true that the top earners in the country are going to see an immediate tax benefit from a full repeal.
So Who The Heck Benefits From This Repeal Without A Replacement Already?
It beats the heck out of us, really. In all seriousness the Senate moving forward with a full repeal without caring about having an actual replacement safety net can only be viewed as pure politics and nothing more than a symbolic gesture on the part of the Republican Senate. For seven years they have been attempting to bring legislation to repeal Obamacare to a vote, most often only to be defeated on the senate floor, and or only to be vetoed by the President. Prior to the actual launch of the ACA they tried to cut it down before it even had a chance to provide healthcare to millions for the first time. For the GOP, which has been complaining about Obamacare for almost a decade, it’s been a lot of frustrating “tough talk” and no real opportunity to “walk the walk” for a very long time. Well now that the moment has unexpectedly arrived and caught everyone off guard, it now seems the ACA is exposed and hard-line Senators such as Mitch McConnell are more concerned about following through on their years of “attempts at a repeal” than the messy aftermath of a quick repeal will actually have.
It seems that any reasonable person would find it hard to argue against a measured response that carefully weighs the consequences, and let’s get to brass tacks, the collateral damage that will be left in its wake.
Are Republicans Setting Themselves Up For A Strained Relationship With The President-elect And Midterm Voters?
Americans have made it clear that they’re only in favor of a repeal and immediate replacement of the ACA. No polling has indicated that anyone is in favor of effectively hanging everyone out to dry, pulling coverage from 20 million, and the probable ensuing market collapse, all so Senate republicans can throw a festival on the ashes of the ACA celebrating their victory.
Additionally a vote to repeal without a replacement could be viewed as a slight against the President-elect and the American people. The repeal would be serving Senate politicians who most Americans in this election cycle seemed to be pretty fed up with, hence Trump’s election. Politicians who are party first and American people second, could find themselves in jeopardy of losing ground in future elections. Considering the enrollment numbers this enrollment season so far, on top of the overwhelming data that indicates Americans aren’t in favor of a repeal without a replacement, and the all but inevitable market collapse that will unfold following a swift repeal, this could be a very dangerous game of political chicken for Republicans.
Which kind of brings us full circle to the question of, are Republican Senators actually listening to the people who elected them to serve in the first place?
If You Have Concerns About A Quick Repeal Without A Replacement – Here’s Your Chance To Make Your Opinion Heard
Below you will find the contact information for all current Republican Senators, who intend to vote for a repeal of Obamacare regardless if there is a replacement plan ready to ensure Americans don’t lose their healthcare coverage or protections provided by parts of the Affordable Care Act. If you have questions about why these Senators would be willing to put not only those currently receiving health insurance benefits under the ACA at risk, but also those who will be covered by President-elect Trump’s plan in the future, you can call or email to let them know directly.
|Jeff Sessions (R-AL)||202-224-4124||Contact|
|Richard Shelby (R-AL)||202-224-5744||Contact|
|Lisa Murkowski (R-AK)||202-224-6665||Contact|
|Dan Sullivan (R-AK)||202-224-3004||Contact|
|Jeff Flake (R-AZ)||202-224-4521||Contact|
|John McCain (R-AZ)||202-224-2235||Contact|
|John Boozman (R-AR)||202-224-4843||Contact|
|Tom Cotton (R-AR)||202-224-2353||Contact|
|Cory Gardner (R-CO)||202-224-5941||Contact|
|Marco Rubio (R-FL)||202-224-3041||Contact|
|Johnny Isakson (R-GA)||202-224-3643||Contact|
|David Perdue (R-GA)||202-224-3521||Contact|
|Mike Crapo (R-ID)||202-224-6142||Contact|
|Jim Risch (R-ID)||202-224-2752||Contact|
|David Purdue (R-GA)||202-224-3521||Contact|
|Todd Young (R-IN)||202-224-5623||Contact|
|Joni Ernst (R-IA)||202-224-3254||Contact|
|Chuck Grassley (R-IA)||202-224-3744||Contact|
|Jerry Moran (R-KS)||202-224-6521||Contact|
|Pat Roberts (R-KS)||202-224-4774||Contact|
|Mitch McConnell (R-KY)||202-224-2541||Contact|
|Rand Paul (R-KY)||202-224-4343||Contact|
|Bill Cassidy (R-LA)||202-224-5824||Contact|
|John Kennedy (R-LA)||202-224-4623||Contact|
|Susan Collins (R-ME)||202-224-2523||Contact|
|Thad Cochran (R-MS)||202-224-5054||Contact|
|Roger Wicker (R-MS)||202-224-6253||Contact|
|Roy Blunt (R-MO)||202-224-5721||Contact|
|Steve Daines (R-MT)||202-224-2651||Contact|
|Deb Fischer (R-NE)||202-224-6551||Contact|
|Ben Sasse (R-NE)||202-224-4224||Contact|
|Dean Heller (R-NV)||202-224-6244||Contact|
|Richard Burr (R-NC)||202-224-3154||Contact|
|Thom Tillis (R-NC)||202-224-6342||Contact|
|John Hoeven (R-ND)||202-224-2551||Contact|
|Rob Portman (R-OH)||202-224-3353||Contact|
|Jim Inhofe (R-OK)||202-224-4721||Contact|
|James Lankford (R-OK)||202-224-5754||Contact|
|Pat Toomey (R-PA)||202-224-4254||Contact|
|Lindsey Graham (R-SC)||202-224-5972||Contact|
|Tim Scott (R-SC)||202-224-6121||Contact|
|Mike Rounds (R-SD)||202-224-5842||Contact|
|John Thune (R-SD)||202-224-2321||Contact|
|Lamar Alexander (R-TN)||202-224-4994||Contact|
|Bob Corker (R-TN)||202-224-3344||Contact|
|John Cornyn (R-TX)||202-224-2934||Contact|
|Ted Cruz (R-TX)||202-224-5922||Contact|
|Orrin Hatch (R-UT)||202-224-5251||Contact|
|Mike Lee (R-UT)||202-224-5444||Contact|
|Shelley Moore Capito
|Ron Johnson (R-WI)||202-224-5323||Contact|
|John Barrasso (R-WY)||202-224-6441||Contact|
|Mike Enzi (R-WY)||202-224-3424||Contact|
Last Updated 12/29/2017
Why Do Some Republicans Seem Intent On Repealing Obamacare, Even Without A Replacement Plan Ready To Go?
When Donald Trump was out on the campaign trail as the GOP presidential nominee, he consistently proclaimed that he would repeal Obamacare on his first day in office. He indicated that he would not simply alter or update Obamacare, he’d completely repeal it. Although after meeting with President Obama, he did in fact say that there are aspects of the ACA that he thinks are worth keeping. This is a positive sign, as it really indicates that President Elect Trump isn’t only going to focus on doing what the GOP advises him is best, for the sake of politics and “optics”. A President should have to make policy decisions that might conflict with even his own administration. That looks to be leadership that’s focused on the people, not political parties and political process, kudos to Trump.
At face value, the Republican Party in general has been against Obamacare since the day it became law in 2010. At every milestone, when new features of the law were preparing to go into effect or problems led to doubt about the process, opponents of the law – largely conservatives – would challenge the Affordable Care Act in court and take their case to the people. Republicans even took parts of Obamacare to the Supreme Court, but challengers lost every battle to replace the ACA.
Why does the Republican party hate Obamacare so much? When you strip away the natural tensions that exist between the two major parties, you’re still left with some pretty interesting reasons why the GOP opposes President Obama’s healthcare reform law. It’s unknown how many of these reasons Donald Trump actually buys into, but he has made it clear that he wants Obamacare gone and replaced with his own version of healthcare reform.
For The GOP That Failed To Repeal It For Years, It’s Personal
The Supreme Court declared Obamacare to be constitutional in 2012, but that did not stop conservative objectors from challenging certain aspects of the law time and again. For instance, Republicans challenged in the Supreme Court in 2016 the provision of the ACA that forced all employers to provide employees with birth control. If companies refused, then the federal government would step in and offer those employees birth control.
The Republican party represents several religious groups that object to the concept of birth control. Contraception clashes with their beliefs, so business leaders challenged a law that seemed in direct opposition to their religious freedoms. The Supreme Court again refused to rule against Obamacare and ordered Congress to find a compromise. There have been a couple of other challenges like this one from the GOP that are solely based on the personal preferences of the Republican Party and its constituents.
Tax Subsidies and Penalties, Unpopular But Necessary
Since Obamacare went into law in 2010, the Republican Party has tried at least 56 times to repeal it without success, often targeting tax penalties and subsidies as reasons why Obamacare needs to be repealed.
According to Republicans, tax penalties are invasive because they force Americans to buy something they may not want to buy. Compelling people to buy coverage goes against conservative ideals of personal liberties. The GOP also feels as though subsidies are wasteful spending that put an unnecessary burden on the American taxpayer. Democrats counter that the subsidies allow millions of Americans to afford insurance who could not afford it before Obamacare. As for the penalties, there are practical reasons for them. No one disputes the idea that forcing people to buy insurance is a hard position to be in, but there are practical reasons for the individual mandate. Without it, young and healthy people might avoid buying insurance, which would drive up costs for everyone else.
A Matter of (Political) Ideology
Obamacare has encouraged the centralization of the health care industry. Under the ACA, the government has taken on a larger role in insurance, both in terms of regulation and administration, so the point that Republicans view Obamacare as a form of “socialized medicine.”
Conservatives believe that the government should stay out of people’s lives and not get involved in any kind of private commerce. Donald Trump’s speeches regarding health insurance have indicated that Trump considers health insurance to be a private enterprise service, and not something that is a “right”. Obamacare interferes with that dynamic. This is just one example of conflicting ideologies. When two groups disagree substantially on a foundational topic, like the government’s role in the private lives of individuals, tensions run high.
Higher Deductibles Are Making Coverage Less Practical
By June 2016, the deductibles for Obamacare health insurance policies reached an average of $7,000 per year. That means that the average consumer has to spend $7,000 out of pocket every year before health insurance kicks in. Needless to say, the GOP has jumped all over this issue and has made it the focal point of its healthcare reform platform.
Rising Premiums Making “Affordable Care” Out Of Reach For Many
Prior to Obamacare, most Americans who had health insurance had employer-sponsored health insurance that may have gone up a little each year to compensate for costs. It’s estimated that premiums on the Obamacare marketplace will go up an average of 25 percent for 2017. That’s a much higher jump than people are used to, and the core of the problem seems to be the way that Obamacare is set up.
Premiums for Obamacare plans are based on participation. The more people buy plans, the lower the premiums can stay. With more companies dropping out of the marketplace and fewer people buying new plans, there just aren’t enough numbers to make prices affordable. Rising premiums coupled with rising deductibles are coming together to create a perfect storm – a storm that Republicans can use to sway public opinion in its favor when they change the law.
There are practical and personal reasons behind Republican bias against Obamacare. Donald Trump won over GOP voters by embracing the repeal-and-replace mantra during his campaign. But when the Republican party only won 52 senate seats instead of the 60 necessary for repeal, it became obvious that Trump could not keep his promise, at least not completely.
Hatred for Obamacare among Republicans is so strong that Congress is expected to approve measures that would gut Obama’s signature health care law and replace it with something else as quickly as possible. What that something else might be is still up in the air. What should be most concerning for Americans is the idea that anyone within government on the left, right, or center, would think first about their political positioning and career before what is actually best for the people they serve. Obamacare is far from perfect, but it has in fact improved the well being of millions who were previously uninsured, and in some cases, that’s saving American lives.
Last Updated 12/12/2016
What is the Republican Plan to Replace Obamacare?
Since the Affordable Care Act became law in 2010, opponents, primarily Republicans, have been trying to repeal it. While Donald Trump was campaigning for the presidency, he took up the mantra of the Republican Party – repeal and replace – which helped him gain traction with conservatives who may not otherwise have voted for him. Trump’s campaign website outlines some of his ideas about healthcare reform, but there has not been anything specific to indicate how he intends to carry out his plans. As we draw nearer to his inauguration in January, Republicans in Congress will need to come to a consensus about how to proceed.
Obamacare is an extensive piece of legislation that reaches into the lives of millions of Americans. It wasn’t until he won the presidential election and started to put his cabinet together that Trump started to release more details about his plan to replace the ACA. It looks like Trump is going to follow the advice of two men who have been leading the charge against Obamacare for years. Dr. Tom Price from Georgia and House Speaker Paul Ryan are at the forefront of the repeal-and-replace movement, and they have a plan that they could drop right into place once Trump takes office.
An Evolving Republican Plan
Tom Price introduced the Empowering Patients First Act in 2009, but his most recent iteration of the bill was released to the 114th Congress in 2015. Each has been intended to be a replacement for Obamacare. Price believes that the ACA puts too much power into the hands of the government, hospitals and doctors in terms of delivery of care. He wants to give patients more and better health care options, and he wants to hold medical care providers accountable for the quality of their care.
It should be noted that Price’s plan is not a complete overhaul of Obamacare. Price agrees with some statutes of Obamacare, and those happen to be the same statutes that Donald Trump supports. Speaker Paul Ryan was one of the Congressional leaders who helped to introduce the Empowering Patients First Act. Ryan is expected to be at the forefront of any changes to Obamacare using the Empowering Patients First Act as a road map.
The Democratic Response
Not unexpectedly, Democrats in Congress were not impressed when Price’s bill was introduced. Democrats contended that Republicans were never serious about the bill because it was never presented as a real bill for the Congress to consider. But now that the GOP runs the show in D.C., Democrats can expect to see real health reform legislation hit the floor that looks a lot like Price’s plan.
What Changes will be Made to Obamacare?
A quick look at the Republican health care reform bill offers better insight into what Trumpcare might become. Highlights include:
- Expanding the availability and limits on Health Savings Accounts
- Helping people move away from employer-sponsored health insurance by offering some form of tax incentives to make the individual purchase of health insurance more affordable
- Setting limits for how much employer-sponsored health care can be offered as tax-free income
- Removing any limitations that may exist in buying and selling health insurance across state lines
- Offering block grants to the states so that they can tailor Medicaid services for their citizens instead of having to follow a growing number of federal rules
- Privatizing Medicare by starting to offer a method for helping seniors to fund their own health plans by 2024
Since the election, the GOP and Ryan specifically have been updating the public on more details regarding changes to Obamacare and Medicare. Donald Trump has been relatively quiet on any of these changes, and Trump has not offered any new information on what he intends to do with Obamacare when he is inaugurated.
From the Democratic Side
While Republicans may be reaching a consensus, it’s not entirely clear what that consensus might be. Several outlets have speculated on how the GOP replacement plan might affect the current American health care system. According to ObamacareFacts.com:
- Costs for healthcare will once again start to skyrocket.
- Pre-existing conditions will again be allowed to affect coverage (Donald Trump has denied this).
- All tax subsidies will be eliminated.
- Eligibility requirements for Medicaid will narrow.
- Tax breaks will favor businesses over individuals.
The truth about what will replace Obamacare is probably somewhere in the middle between what the GOP is saying and what the Democrats are saying. Trump himself has shifted his position several times, and his latest insistence is that he wants to keep key parts of Obamacare in place. Much of the ACA’s future – and with it, the future of 22 million people who have coverage thanks to Obamacare – depends on what happens once Trump takes office in January.
Trumpcare’s Potential Premium Deductions
Health insurance, specifically the Affordable Care Act (ACA), was a prime talking point during the 2016 presidential campaign. Republican nominee Donald Trump promised to repeal the ACA the moment he took office. But since the GOP only has 52 senate seats instead of the 60 needed for a repeal, it is unlikely that Trump will be able to keep his campaign promise.
Despite not having a two-thirds majority in the senate, Trump can still make significant changes to the ACA that would permanently and completely alter the way it looks and works. One of the areas where Trump wants to make changes is by creating premium deductions for individuals. In order to understand what Trump wants to do here, we need to first look at how individuals are currently able to treat health insurance premiums on their taxes.
Taxes and Health Insurance
Health insurance premiums are considered non-taxable income for you and your employer. That’s why your premiums are taken out of your pay in pre-tax dollars. Your employer is also able to deduct the portion of your health insurance premiums that it pays, making sure that health insurance premiums are basically a non-tax event.
The ACA made a few changes to health insurance related taxes that affect everyone. If the medical and dental expenses you pay out of pocket exceed 10 percent of your gross income, then you can use the portion over 10 percent as a deduction. If you pay certain for certain medical expenses out of your own pocket, such as the cost for medical transportation, then you can deduct that from your taxes as well.
While you cannot claim any money that you paid into a Health Savings Account (HSA), the good news is that you can use that money tax-free to cover medical expenses. The ACA also allows you to deduct any out-of-pocket expenses you paid to drive to a medical care facility. This means that your transportation to a hospital, whether it is by car or ambulance, is tax deductible.
Trumpcare Tax Subsidies
Under the ACA, any consumer with an income that is less than 400 percent of the federal poverty line can get some kind of tax subsidy to help with the costs of health insurance. Anyone who makes less than 250 percent of the federal poverty line will have access to cost-sharing reduction subsidies that help to absorb more of the medical costs you paid out of your own pocket for the year. Tax credits are applied up front by most people. The cost-sharing program is applied when you file your taxes, so it works as a reimbursement.
If you do not have a qualifying health insurance plan in place throughout the year and are not exempt from having coverage, then you risk paying a federal income tax penalty. Exemptions exist for certain groups of people, like members of Native American tribes, religious organizations that object to health insurance, and people who are incarcerated.
In 2016, the penalty was $695 for each uninsured adult and $347.50 for each uninsured child in your family, or 2.5 percent of your family’s total taxable income, whichever was higher. The Obama administration uses the penalty as a way of motivating people to buy insurance and help keep overall costs down for everyone. Opponents of the law view the individual mandate as invasive, and Republicans have vowed to eliminate it once Trump takes office.
Taxes under Trumpcare
Donald Trump’s take on health insurance taxes is confusing and vague. For example, he wants to allow everyone to be able to use the tax-free HSA program, but he doesn’t indicate if that includes people without health insurance as well.
The most significant tax change Trump wants to make with his health insurance reforms is to allow everyone who pays insurance premiums to a private insurance company to be able to deduct those premiums. In other words, if you buy your health insurance directly from an insurance company, then Trump wants your premiums to be in pre-tax dollars, just like anyone who has employer-sponsored insurance.
There are two issues with this plan that render it useless. First, the Huffington Post ran the numbers and determined that offering this sort of tax deduction to private insurance buyers is not the same as getting employer-sponsored health insurance. While the deduction helps, consumers are still better off getting their insurance through their employers.
Trump points to how much his premium deductions will help small businesses and self-employed workers, but both groups can already write off health insurance premiums from their taxes. In essence, Trump’s most significant health insurance premium deduction is actually nothing new, and it does not help as much as he thinks it will.
Right now, health insurance premiums are considered non-taxable income by the IRS. That means that anyone who pays their own premiums in full, businesses or individuals, can deduct those premiums on their taxes. Donald Trump’s plan does little more than reinforce laws that already exist, which does nothing to promote health insurance reform or ease the financial burden of individual consumers.
President-Elect Trump Selects Tom Price of Georgia For “Trumpcare” Cabinet Position
The President-Elect announced on Tuesday his selection for Secrtary of HHS, also known as Health and Human Services. The individual who fills this position will largely influence how Americans obtain healthcare within the USA for the next four years, or longer.
Tom Price as the section is not a surprise, as Dr. Tom Price, Representative for the state of Georgia, and a former orthopedic surgeon, has consistently been a fierce critic of Obamacare, and has called for moving quickly to shut-down parts of the law through the budget reconciliation process. Price is expected to have his own proposal for healthcare reform, it is however believed that what he and the Trump administration end up moving forward with, will be very similar to Paul Ryan’s “Better Way” proposal. It should be noted that until finalized plans have been fully committed to, everything that we can report on, nor anyone else can report on with respect to what “Trumpcare” will offer Americans, as of today is still speculation. We will continue to update Trumpcare.com on a daily basis with factual information.
With respect what Americans should be doing with respect to their healthcare options for the next 12 months, nothing has changed, and most likely nothing will change in a material way, for six months or more. Much of what President-Elect Trump has proposed on the campaign trail and since the election, will take, as the expression goes, “an act of congress”.
So what should you do if you’re now in a position where you have to find a new healthcare plan or face the tax penalty? First of all, you should always be insured. Not having health insurance coverage is literally gambling with you and or your families future. Medical debt is what forces most Americans into bankruptcy. You don’t need to get cancer to end up with $500,000 in medical debt. A car accident, an accident at work or at home can lead to major surgeries and massive expenses.
Your best course of action, is to simply shop for an affordable health insurance plan now, enroll in a plan that you can make work, and then when President-Elect Trump’s healthcare reform plan fully goes into effect, your options may prove to be better. At that point you can switch to something else, but until then, don’t risk your life and happiness while the politics play out.
Post Election Update Regarding Trumpcare
On Nov. 8, Donald Trump was elected President of the U.S. and while Republicans are cheering in victory, millions of people across the country are now wondering what the future holds – especially when it comes to their health insurance. Under President Obama, the Affordable Care Act granted access to health insurance for people who didn’t have it before. Low-income families, young adults still living at home and people with pre-existing conditions gained affordable coverage for the first time. President-elect Trump has vowed to repeal and replace the ACA, leaving many to wonder what will happen to their health insurance in the aftermath.
What is Trump’s plan for Obamacare and Trumpcare?
For starters, Trump has promised to repeal and replace the Affordable Care Act. Over the last six years, the ACA has made it possible for people from different walks of life to find and buy health insurance in a new way. To his credit, Trump has also promised to take care of people “better than they’re taken care of now.” Details on this promise have yet to be released. How Trump envisions taking care of people without a health insurance mandate, or put another way, requiring everyone to have health insurance, remains to be seen.
In a nutshell, here are Trump’s proposals for replacing the ACA:
- Completely repeal the Affordable Care Act, including the individual mandate that requires people to have health insurance.
- Allow the sale of health insurance across state lines.
- Enable individuals to deduct health insurance premiums from their taxes, a practice that businesses are already able to do.
- Enhance and promote Health Savings Accounts (HSAs) for individuals who want to set money aside for health care. HSAs would become more robust under Trump’s plan.
- Require medical providers and health care professionals to provide clear pricing to consumers so that people have the chance to shop around for the best deal.
- Convert Medicaid’s current match funding program to a block-grant program.
- Allow consumers to purchase prescription medication from out of the United States, provided that they’re safe and meet U.S. guidelines for prescriptions.
Much of Trump’s health care plan centers on the free market. There would be no mandate to buy health insurance, and as far as has been proposed, no tax subsidies to make health insurance affordable for people who can’t buy coverage. Some of these proposals seem beneficial, but for the 20 million Americans who have gained coverage since the passage of the ACA, Trump’s proposal to repeal Obamacare entirely is worrisome.
What happens to my insurance if the ACA is repealed?
It’s unlikely that Trump will simply scrap Obamacare altogether as he promised to do on his first day in office. There are politically advantageous reasons for keeping certain aspects of the law in place. Instead, the new administration will likely rework key features of the current health care law to make it virtually unrecognizable. The difference might seem like splitting hairs, but undoing a law like the ACA requires greater political maneuvering than simply tossing it aside and starting over.
Another issue to keep in mind is that repealing the ACA will be very difficult considering that Trump and his Republicans do not have a Supermajority in the Senate, which means they don’t hold 60% of the votes to pass anything they want. This also means that the Democrats can protect the ACA by voting again for a repeal.
Hypothetically though, if Trump were able to scrap the entire law sometime next year, here are a couple of things that you could expect to happen:
- Your current premiums might go up, especially if you receive tax subsidies to offset the cost. There won’t be tax credits to make insurance less expensive. For example, if your current family plan costs $350 a month with $400 in subsidies, then the total cost would now be the full $750 a month.
- Because there’s no mention of the 10 essential benefits that currently exist under the ACA, your coverage could change dramatically. You could pay more for certain services, like preventive care or hospitalization.
- If you have Medicaid, then you may lose this coverage in states that opted to expand medicaid under Obamacare. Trump wants to fund Medicaid through block grants, which could affect the amount of money that each state has to spend on the program.
You will probably have to make some adjustments – and pay higher premiums – but there may be upsides to Trump’s proposals as well. Clearer pricing could help you to make better decisions about where to receive treatment, and enabling overseas drug companies to compete in the U.S. market may help to drive down prescription costs.
Changing Obamacare could be easier with a Republican Congress, but the backlash from forcing 20 million people to lose their health insurance could keep Trump from following through on his promise to throw out the ACA. In any case, it’s extremely unlikely that you will simply lose your coverage in the middle of a plan year.
Should I bother signing up for 2017 coverage?
In light of 2016 election results, you may be tempted to avoid signing up for health insurance for 2017. With a Republican at the helm – and one who appears to be focused on repealing and replacing the Affordable Care Act in its entirety – it seems likely that there will be substantial changes made to the health care law over the next four years. However, it’s still important to enroll in a health insurance plan. In fact, it’s probably more important now than ever to do it while you can.
Under the ACA, you’re guaranteed coverage for certain things, like preventive care, surgery and prenatal services. You can’t be denied a plan because you have a pre-existing condition, and your insurer can’t drop your coverage without a good, clearly defined reason. There are also limits to your out-of-pocket costs. Premiums are cheaper for most people thanks to subsidies. In short, there are benefits to having health insurance that go beyond simply being able to pay for medical care.
These benefits may change under a Trump presidency, but Trump will not assume the role of president until the end of January. It will take time to repeal and replace the ACA, if it happens at all during his first year as president. Now is the time to enroll in an affordable health insurance plan, while the marketplaces are still open and tax credits are still available. Open enrollment lasts until Jan. 31. Sign up now to secure coverage for yourself and your family in 2017. If you choose not to enroll during the 2017 open enrollment period, you may spend the entire year without coverage and the ability to enroll again. That will be catastrophic if you or a family member in your household finds themselves in the hospital, facing mounting medical bills that you are now responsible to pay personally.
Yes, it is true that the longterm future of the ACA as we have known it for the last several years is uncertain, but what is certain is that people need health insurance to get healthier and to stay healthy so if you want coverage at all during the 2017 calendar year, you must enroll during the open enrollment period, which started on November 1st and ends on January 31st.
You must enroll by December 15th to have coverage starting on January 1st.
This website is dedicated to providing factual information about the proposed healthcare reform of presidential candidate, Donald J. Trump, and what has been called by various individuals and media sources as Trumpcare. In no way is this website connected to, or controlled by, any political party, political figure, PAC, or Donald J. Trump. The sole purpose of this website is simply to provide factual, unbiased information about Donald J. Trump’s proposed healthcare reform policies. This site will be continually updated with information as it becomes available.
Donald J. Trump released more details of his healthcare reform plan, which many have coined as Trumpcare, on March 3, 2016 to, in his words, “Make America Great Again. Trump explains that he wants to add free market principles to his healthcare plan that will bring economic freedom and security to America and that his overall goal, according to his website, is to “broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.”
At the close of Mr. Trump’s written proposal for healthcare reform, he states that he may consider and adopt other ideas so long as it brings down the overall costs of medical coverage to Americans.
We provide a detailed analysis of his seven-point plan for healthcare reform below.
Trumpcare Seven Point Healthcare Reform Plan
Step 1: Repeal Obamacare
According to Donald J. Trump’s website, the Affordable Care Act, which is also known as Obamacare, must be repealed in its entirety. He states that he will call on Congress to get this done on day one of his presidency. This complete repeal would also include the individual mandate that requires every American, unless they are excluded for a specific reason, to have health insurance coverage that meets the minimum essential required benefits or pay a tax penalty. According to the statement on Trump’s website, no individual should be forced to purchase health insurance if they do not want it.
Step 2: Allow Insurance Carriers to Sell Health Insurance Policies Across State Lines
According to the information published on his website, Donald Trump believes that if insurance carriers were permitted to sell individual plans across state lines, provided they comply with each state’s individual requirements for coverage, the increased competition within each state would result in a more competitive marketplace and overall lower costs for consumers seeking health insurance.
Step 3: Health Insurance Premium Costs Should Be a Tax Deduction
Mr. Trump believes that an individual or family should be allowed to deduct the total costs of their monthly premiums (the monthly payment required in order to have active health insurance coverage) from their annual health federal income taxes. He reasons that if an employer offered health insurance to its employees, those costs would be a deduction to the company so it should work the same for individuals and families.
As part of this step, Donald Trump also presents that we should review Medicaid (insurance for lower income families) and make sure that states offer coverage to those who want it. Prior to the Affordable Care Act, Medicaid was only offered to pregnant women, children, elderly and disabled individuals and parents in specific circumstances. Medicaid did not cover low income adults though until the Affordable Care Act (Obamacare) was passed. A full repeal of Obamacare would obviously undo the Medicaid expansion as well. Donald Trump’s healthcare reform plan, Trumpcare, does not specifically explain whether he would keep any expansion of Medicaid, only that the plan needs to be reviewed.
Step 4: Allow people to use HSAs to pay their out-of-pocket health costs
Health Savings Accounts (HSAs) are savings accounts that are personal to the individual but can be funded not only by the individual, but also an employer. Donald Trump proposes that all individuals should be allowed to open an HSA. Presently, the IRS only allows certain individuals to open HSAs. Those people are:
- People who have a high deductible health plan (HDHP) meaning that your plan has a higher annual deductible than most;
- Those who have no other type of health insurance coverage;
- Those who are not enrolled in Medicare; and
- Those who cannot be claimed as a dependent by someone’s tax return for the preceding year.
Another restriction places on HSAs by the IRS presently is that HSAs may not be shared among family members. Every person in the family covered by a high deductible plan must have their only HSA.
Step 4 of Trumpcare stipulations that HSAs would be readily available to anyone who wanted to open one, meaning he would remove the IRS’ requirements, they could be shared among family members and passed on to heirs upon the HSA owner’s passing. Most importantly, Donald Trump would not disturb the characteristic of HSAs that makes them tax-free if the funds are used for medical expenses. Furthermore, if a person included the HSA funds in their estate upon passing, the money in the fund would pass to their heirs without being subject to any state or federal estate or death tax.
Mr. Trump anticipates that offering HSAs to all Americans would be particularly attractive to young people who would rather put money away into an account, tax-free, to accumulate over the years and pay the cost of a high deductible health plan that they may hardly use because they are healthy instead of getting a more expensive plan from the beginning.
Step 5: Price transparency from healthcare providers
Trumpcare’s fifth step states that Mr. Trump would demand that healthcare organizations like hospitals and rehab centers and healthcare providers like doctors must reveal the full costs of their services so that people can shop around for the best price, presuming they have multiple choices under their health insurance plan.
Although Donald Trump does not supply further explanation or rational, the concept behind this step is akin to the free market principles he wanted to inject into his healthcare reform.
Step 6: Stop federal financial Medicaid grants to the states
Another principle at the heart of Mr. Trump’s healthcare reform is the fact that we will save money used to fund public health programs like Medicaid and CHIP (Children’s Health Insurance Program) if we improve the economy and provide Americans with more jobs.
Presently, the federal government jointly funds the Medicaid program with the states. States receive funding from the federal government for the Medicaid program in several ways.
First, they receive a Federal Medicaid Assistance Percentage for every dollar spent by the state on Medicaid expenses. At the bare minimum, the state will receive $1.00 from the federal government for every dollar the state spends.
Second, if a state chose to expand Medicaid eligibility under Obamacare, the federal government will reimburse the state 100% of the additional costs incurred by the state for those newly eligible citizens until 2016. The reimbursement amount to the state decreases over the years until it hits 90% in 2020 according to the law.
Third, if a hospital serves a large number of Medicaid and uninsured patients, they will receive DSH payments or Disproportionate Share Hospital payments, from the federal government. This money makes up for the amount of money that the hospitals are not receiving for the services they provide to Medicaid and uninsured people in their state.
Fourth, a state may apply funds from other buckets of general funds to the Medicaid program.
Unfortunately, Donald Trump’s healthcare reform plan on DonaldJTrump.com does not specifically explain whether he would rid the Medicaid program of all of the federal aid outlined above, but he does state that he wants the control and management of the Medicaid program to stay in the hands of the states that know their people the best. He states that if the authority to manage Medicaid is with the states alone, they will have the incentive to eliminate fraud and financial waste. Presumably, this is due to the fact that the states would be funding Medicaid entirely on their own so they would be more protective and watchful of where the money is going.
Step 7: Remove barriers for drug providers
Trumpcare’s final proposed step to bring healthcare reform that will lower healthcare costs for Americans is to remove restrictions on drugs providers that would allow them to offer their brand and generic prescription drugs to the free market for a lower cost.
Mr. Trump admits that this step will require Congress to end their alliance and allegiance to special interest pharmaceutical groups. Donald Trump believes that allowing Americans to shop for and purchase and import pharmaceutical drugs that are safe and reliable from overseas companies will bring down the costs of prescription drugs across the board because it will increase competition.
Although not a specially outlined step of Trumpcare, Donald Trump closes out his proposal for healthcare reform by remarking that there are other ancillary initiatives that he is planning during his presidency that will have an effect on healthcare.
For instance, Trump believes that policies that enforce immigration laws and stop fraud and financial waste of the healthcare sector will improve the economy. Regarding immigration, Donald Trump states that providing healthcare to people who are in this country illegally costs the country $11 billion a year and immigration policies and more restrictions on visas will save a lot of that money.
Additionally, Donald J. Trump believes that there needs to be reform to our mental health programs and facilities. He states that there are currently initiatives in Congress that will help families who need information and access to assistance for their family members ailing from mental disease and that those bills should receive bi-partisan support.
We will continue to update this briefing of Trumpcare as more details are revealed and discussed.