The Affordable Care Act was nicknamed “Obamacare” because the law’s primary champion was former President Obama. But the president wasn’t acting alone when he signed the bill into law. Healthcare reform takes time, effort and energy from a lot of different people, a fact that hasn’t changed since President Trump took office in January. The new president is unafraid to share his opinions on the future of the country, but he isn’t working alone, either. Trump continues to surround himself with controversial figures.
These controversial figures will undoubtedly play critical roles in shaping the American healthcare system under a Republican president and Congress. As we speculate on the future of the country, it’s important to note the players involved. Tom Price, newly elected secretary of health and human services; Gary Cohn, chief economic advisor to the president; and Lamar Alexander, senator from Tennessee, are three new names to watch this year.
Recently confirmed as head of the Department of Health and Human Services (HHS), Secretary Tom Price is the first medical doctor to hold the position since 1993. Price has never supported the Affordable Care Act, and it’s expected that he will wade through key regulations to overhaul the law. The confirmation process for Price was heated, eventually coming down to a party-line vote. Here are some of facts about Price that will influence his decisions as head of the HHS:
- As the former chairman of the House Budget Committee and a doctor, Price has experience in healthcare policy from a political and personal level.
- A strong believer in a healthcare system that is privatized, Price is opposed to healthcare being run by the federal government. When it comes to Medicaid, he believes that each individual state should have control over how to use potential block grants for funding.
- He and House Speaker Paul Ryan share the same views on how Medicare should be funded, using a voucher system with fixed dollar amounts for each beneficiary rather than a percentage covered by the government. While seniors could see an increase in healthcare costs, some claim this is the only thing that will keep the 50-year-old system from going completely bankrupt. It’s not clear at this point if this view is shared by President Trump.
- Price is pro-life and anti-abortion, and would like to pull federal funding for programs that support abortion, including Planned Parenthood.
The Georgia congressman believes that there is a solution that will work for everyone involved, and has been quoted saying:
There is much work to be done to ensure we have a healthcare system that works for patients, families, and doctors; that leads the world in the cure and prevention of illness; and that is based on sensible rules to protect the well-being of the country while embracing its innovative spirit.
President Trump’s chief economic advisor is Gary Cohn, a Democrat who previously held the position of chief operating officer at Goldman Sachs. While Cohn does not have a history in healthcare, he does have enormous financial and business experience to add to healthcare policy changes. Cohn has been working closely with Republicans like Paul Ryan to not only repeal but replace the Affordable Care Act. Although his experience is largely related to mortgages and commodity trading, Cohn brings an interesting perspective to healthcare reform:
- As a Democrat, Cohn is positioned to appeal to fellow Democrats once Republicans put together and attempt to implement their plan for repealing and replacing Obamacare. Since he sides with Trump on repeal, he already departs from the standard party view, but his position as a Democrat could give him clout with other Democrats on Capitol Hill.
- His financial and tax law experience will be beneficial to repealing and replacing given the complex structure of the ACA. Having someone with his background at the table will round out the discussion of reform, especially when it’s tempered by people with medical experience, such as Tom Price.
There is concern that as a businessman, Gary Cohn lacks the necessary experience to advise Trump on healthcare policy. It does not sit well with some that an investment banker will be the one who’s going through the ACA with a fine-tooth comb. However, it has been reported that Cohn is working closely with an unnamed healthcare specialist, and we don’t know at this point the extent to which he will be involved in creating healthcare legislation.
Working as a voice of calm for the Republican Party is Senator Lamar Alexander (R-Tenn.), the current chair of the Senate Health, Education, Labor and Pensions Committee. Alexander has been quietly waging a war of reason among his peers in Congress, handing out notecards with bullet points of his own ideas about healthcare reform. The senior senator from Tennessee has taken a keen interest in the future of the American healthcare system while not asserting his views as vigorously as other members of his party. If there’s one congressman who might bring the two parties to the same table, it’s Alexander. Here are a few points worth noting about the “stealth Republican force behind Obamacare repeal”:
- The senator does not have his own healthcare plan, and he does not plan on proposing one to compete with the plans already on the table. Instead, he wants to work with Tom Price, Paul Ryan and the president to develop a single plan that represents the party while taking into account the Democrats’ concerns.
- Senator Alexander believes that one of the biggest inhibitors to affordable healthcare is the inability of insurance companies to compete across state lines, and he would like to enact a plan in which this competition would be possible.
- Some Republicans, particularly President pro tempore of the Senate and Finance Committee Chair Orrin Hatch, do not believe that Alexander will have much influence on the current administration because he is not close to President Trump, having only met him twice so far. However, Alexander does have close relationships with Paul Ryan and Tom Price, who have been working with Trump on healthcare reform since inauguration.
- Alexander’s great working relationship with Senate Democrats means that he could be influential in uniting the two parties to a common plan.
The senator’s calm and rational approach to a subject that has brought much conflict in the senate is a breath of fresh air as he’s working tirelessly to help Republicans unite among themselves before attempting cross-party negotiations. He understands that quick changes are not always well thought out, and that slower moves to a new system will not only help make for a better healthcare plan, but help people understand that it’s possible to have differing opinions without being divisive or unnecessarily hostile. He told Politico, “What I’m trying to do is to make sure that we think carefully. We’re moving from a position – repeal and replace – to governing. It’s a little more complicated.”
The next few years will be interesting, to say the least, as we watch and wait to see the changes that the Trump administration makes to America’s healthcare system. While speculation and fears run rampant, one thing is certain, and that’s that restructuring healthcare in a way where everyone benefits is no small task.