Please note that this section within Trumpcare.com was published before the outcome of the 2016 Presidential Election. Donald Trump, a Republican party candidate for president of the United States in 2016, has become a major challenger for the role. As the issue of health care reform continues to be hotly debated, the Democratic party candidate, Hillary Clinton is a formidable adversary. This article attempts to explain how Trump’s position on The Affordable Care Act and subsequent ideas for reform came about and how it differs from Clinton’s, beginning with a full review of Trump’s developing plan.
Donald Trump: The America We Deserve
- Trump wrote a book titled, The America We Deserve, back in 2000. In it he explained how U.S. citizens should have universal healthcare modeled after the Federal Employees Health Benefits program saying, “Our objective [should be] to make reforms for the moment and, longer term, to find an equivalent of the single-payer plan that is affordable, well-administered, and provides freedom of choice.” This existing program can be a template for all healthcare reform. The government acts, in this case, as a centralized agency that offers a market-based variety of choices.
In 2011, he expanded on previous ideas by adding the ability for consumers to purchase health care plans across state lines to increase competition between insurance companies and decrease pricing for the buyer.
By September 2013, Trump stated that Obamacare was a complete disaster that was ruining the economy and would eventually “shut down this country.” He still believed a universal health care plan was needed, but in a government controlled and funded system. He spoke of the single-payer health care systems of Canada and Scotland as solid health care plan models.
Trump’s Arguments Against Obamacare
Trump is certain that Obamacare was a complete failure and if it continues into 2016 the complications involved in health care services will cause doctors and health-related businesses to close their doors. Trump cites one of his own personal friends as a frustrated physician currently experiencing this situation.
In an interview with Forbes in 2015, a Trump spokesperson explained how the ACA would be replaced by a free enterprise concept that returns authority to the states. The plan would break up health insurance company monopolies and lower barriers to enable buyers to purchase products over state lines. This would create more choices for consumers and competition between companies because some states have large numbers of insurance mandates driving up the cost of coverage while others don’t.
Trump talks about individual tax relief to keep plans manageable and affordable. That relief would come in the form of deductions for health insurance premiums on income taxes and by encouraging the use of tax-free health savings accounts to help cover expenses that are not paid for by health insurance plans.
He proposes changes to the government health insurance program, Medicaid, for the poor and disabled by replacing current cost sharing programs with annual fixed amounts of money to each state. By block-granting Medicaid this way, the government overspending caused by splitting the funding between states and the federal government can be avoided.
- Trump’s provisions are viewed differently depending on how you interpret them. Intending to provide more benefits to low-income people initially, it could instead create a new tax loophole of open-ended tax breaks and people with smaller incomes, who pay less in taxes, would actually see much smaller benefits than citizens with larger incomes.
Trump’s policies seem to conflict at times with his assurances to provide health care to all Americans. He has not elaborated on the details to providing more coverage to people with pre-existing conditions or offered a new financing system to provide health insurance for poor citizens when Obamacare is repealed.
Hillary wants to continue to improve on The Affordable Care Act with new provisions for reform. She is concerned about the removal of the pre-existing conditions clause and coverage provided to low-income citizens through Medicaid in many states and Trump’s abilities to come up with an entirely new solution.
Trump And the Problem with Medicaid
Republicans agree with Trump’s goal to repeal the Affordable Care Act, but worry Trump’s plan might involve a huge Medicaid expansion. Trump isn’t talking about expansion or cost controls, and without specifics, it is uncertain what the American public will have to replace the current healthcare plan.
Repealing the ACA would result in a large tax cut of over $1 trillion over the next 10 years. Republicans are calling to dismantle it due to 20 new or higher taxes in Obamacare that would be instantly eliminated. One of these is the 3.8 percent tax on wages, earned income, and investment income on families making over $250,000 annually. The investment income tax does not take inflation into account and may be the biggest reason for taxes rising from 18 percent to 24 percent of our economic yield this century according to the Congressional Budget Office.
However, just repealing Obamacare will not effectively solve the problem. Trump also believes tax refunds on premium payments are necessary and enforcing immigration laws could result in lower healthcare costs by eliminating a sector of people he believes our health system should not be supporting.
Trump intends to work with Congress to make sure there is a series of reforms ready for implementation following free market principles to restore economic freedom for everyone and create sound public policy broadening health care access, making healthcare more affordable, and improving the quality of care and coverage available to all citizens.
“Making America Great Again”
Trump’s more detailed seven-point healthcare reform plan dubbed “healthcare reform to make America great again,” was released in December 2016 to clarify his earlier statements after being accused of being a bit vague. This is his sixth policy paper and the only one that outlines his health care reform plan.
- Reverse the McCarran-Ferguson Act, a federal law that exempts the insurance industry from most federal regulations, and allows the sale of insurance across state lines. “By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.”
- Allow taxpayers to fully deduct health insurance premium payments on their tax returns, as businesses can. The plan asks: “Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions?”
- Review basic options for Medicaid and work with states to ensure that those who want health care coverage can have it.
- Allow all individuals to use Health Savings Accounts (HSA), make those contributions tax-free, and let them accumulate funds indefinitely. Make HSAs part of an individual’s estate, able to be passed on to heirs without fear of any death penalty.
- Require price transparency from all healthcare providers, including clinics and hospitals.
- Block-grant Medicaid to the states. Incentivize the states to seek out and eliminate fraud, waste and abuse to preserve government resources.
- Remove barriers to entry into the pharmaceutical industry for drug providers that offer safe, generic options. Trump states, “Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service.”
Trump’s actions for health care reform are found in other policy areas he believes will affect healthcare costs and burdens such as enforcing immigration law and removing programs that contribute to fraud and overspending. Removing these stressors on the economy will relieve the financial pressures felt by every American.
Comparison to Hillary Clinton’s Plan (Hillarycare)
Affordable Care Act
At the eighth Republican presidential primary debate in February 2016, Donald Trump discussed his health care plan and how it relates to Hillary Clinton‘s. He feels it is plain common sense to replace Obamacare because insurance companies are the only ones benefiting financially from the law. The savings from repealing the ACA’s 20 related tax increases over the next 10 years could be part of the funding needed to address a replacement system, but that has not been made clear.
Clinton believes scrapping the whole Affordable Care Act would cause economic upheaval and is not necessary. Continuing forward with incremental changes to problem areas in the current system would make more sense. She believes Trump simply wants to get rid of Obamacare.
Trumpcare And Where Funding for Proposed Changes Would Come From
A big difference in these two candidates, beyond being at opposite poles on the issue of the ACA, is simply releasing policy information. Trump’s most detailed proposal deals with his tax plan released in September. It would end income taxes for low-income citizens, reduce the current seven tax brackets to four, decrease corporate taxes and raise taxes on the wealthy. There may be savings in here that relates to funding his health care replacement plan but there are no details to support it as yet.
Hillary has submitted multiple papers on how she will go forward to correct specific problems with the marketplace, competition between health insurance providers and drug companies, reducing related costs to consumers, and allowing the purchase of drugs from other countries. She has plans to use Bush tax cut funds, suggested ways to save the government money, estimating she could raise at least $1 trillion toward proposal costs.
These candidates have very different personalities and approaches. Clinton, a former secretary of state, senator, and first lady presents a skilled and knowledgeable public servant with expertise in the importance of details. “I’m going to tell you what I will do and I will tell you how much I pay for it and you should ask that of everybody,” Clinton says often.
Trump presents a successful businessman who demands action, largely staying clear of the specifics, asking the citizens of the US to trust his exceptional business and deal-making abilities.
Trumpcare And Premium Payments Tax Exemption
Deducting the cost of health insurance premium payments from individual tax returns is part of Trump’s plan to make sure that both businesses and individuals are allowed the same exemptions. The group of people affected by the premium deduction will be those buying individual market health insurance, not self-employed, with a tax liability.
Clinton, having a hand in current health care legislation, knows almost 50 percent of tax filers do not have income tax liability and an additional deduction will not affect them. Such as:
- Americans already receiving federal aid through Medicare coverage and pay a portion of their Parts B and D premiums. Medicare is primarily for people over 65, or who qualify for disability and are unable to work.
- Nearly all Americans getting health coverage from work already get a tax deduction for their portion of the premiums through an adjustment in their paychecks.
- Many Americans currently qualify for free health insurance from Medicaid, the Veterans Administration, Tricare, or CHIP.
- Self-employed people, sole proprietors, partners, and S-corporations are able to deduct premiums individually as well.
Trump will need to address how his replacement health care system would impact low-income citizens currently dependent on government programs.
Trumpcare And The Health Savings Account Connection
Trump suggests the HSA would be better than high-deductibles plans. The Health Savings Accounts (HSA) have been around since 2003 and created by Congress when they addressed the Medicare Part D prescription drug benefit. Contributions into HSAs are currently tax-free, allowed to accrue funds, can be passed to heirs as part of their estate, and can be used by family members without penalty. Twenty million Americans have an HSA and that translates to “about 15% of people with private sector health insurance” and average premiums for qualified plans are $14,000 per year for families and about $6000 per year for individuals.
Hillary does not feel this is an adequate solution as a replacement for the Affordable Care Act.
Trumpcare, Immigration and Healthcare – Oh My!
The immigration issue, for Trump, affects the healthcare system in the US by overwhelming by covering people who aren’t citizens. They should not be entitled to purchase or use our health care plans. In addition, he believes if we could enforce the current immigration laws and restrict the granting of visas, we could get rid much of the financial pressure related to healthcare on the state and local governments level. Providing healthcare to illegal immigrants costs roughly $11 billion annually.
Hillary wants to insure everyone, especially children, and would not turn down an immigrant who wants to purchase a plan in the marketplace.
Trump And The Pharmaceutical Industry
Trump believes that market competition alone may not solve the issue of price gouging the American public. Congress may need to intervene in some way to regulate the industry. He would also allow importing foreign drugs despite his views on foreign trade in general. In other areas, he is focused on more trade restrictions to increase business and jobs in America.
Clinton believes it may be necessary to regulate pricing on the Pharmaceutical companies.
Donald J. Trump’s Experience
Trump has no prior experience in health reform, but his experience with government comes from being a business owner and spending time dealing with the political system from the local to the international level to develop ideas about what is, and is not, working. Donald campaigned for the U.S. presidency in 2000 and won two Reform Party primaries before pulling out. He floated the idea of running for president in 1988, 2004, and 2012, and for Governor of New York in 2006 and 2014, but until he announced his candidacy in 2015, Mr. Trump never held a political office. However, he managed to become the Republican front-runner and has won 15 contests in the 2016 Republican presidential primaries as of March 2016.
Clinton personally worked on creating a new universal healthcare law since 1993 with the Bill Clinton’s Health Security Act as First Lady. She advocated for support to help with health issues of first responders after the terrorist attacks in NY while serving as a senator in 2001. In 2008, she presented a universal healthcare plan to mandate insurance coverage for all Americans that contributed to Obama’s ACA law in 2008.
lthough there have been presidents in history with few political credentials, Trump would be the only president with no prior political office or military background at all. Many of his supporters will argue what we need is to get a non-politician into the white house to clean out the executive branch and get our financial house in order.
A Quick Look at Specific Issues
- Pro-life and in favor of cutting funding to planned parenthood, supports Hyde Amendment exceptions
- Address Veteran’s Health Administration needs to increase technology, support for female veterans and provide more clinics and hospitals in rural areas
- Refueled the debate on vaccines and the previous view that they might contribute to autism
- Alzheimer’s research is a top priority
- Block-grant Medicaid contributions and reduce federally funded programs overall
- Companies should provide on-site day care, but not necessary increase or mandate the amount of paid maternity or paternity leave
- Has concern for opioid abuse and relates the issue to closing the Mexican border
- Create a new health care system that is competitive and reducing costs for insurance, services and prescription drugs
- Reform mental health programs providing more tools and information to families needing support
- Pro-choice and defends planned parenthood
- Agrees the Veteran’s Health Administration needs technology upgrades to improve timely service and quality health care and providing better health care services in rural areas
- Increase funding for Alzheimer’s research and screening, treating and funding of Autism
- Increase treatment and recovery programs related to addictions to heroin and supply alternatives drugs as painkillers to stop opioid overdose fatalities.
- Continue to fund Medicaid, Medicare, other federal programs
- Require 7 days of paid sick leave, 3 months of paid leave for new parents
- Expand existing health care system for coverage, reducing costs insurance, services and prescription drugs
- Mental health should be treated the same as physical health
Conclusion Of Trumpcare VS Hillarycare
Trump explains that reforming healthcare requires a President with leadership skills to encourage and engage US citizens and persuade Congress to make changes for the benefit of the entire population. He believes his reforms are straightforward and will “Make America Great Again”.
Republicans, in general, realize reform effort must begin with Congress. Since the ACA law was passed, conservatives have been presenting reforms both as individual proposals and part of more comprehensive efforts. Trump has several reforms to offer Congress on the first day of his administration to immediately begin restoring government trust and economic freedom to US citizens.
- Trump believes having a job is the most effective social program and aims to reduce dependence on public health programs. Reducing the number of individuals needing programs like Medicaid and the Children’s Health Insurance Program is necessary to install new programs aimed at growing the economy and bringing jobs back to the United States.
According to Trump and most republicans, The Affordable Care Act has caused American’s to suffer extreme economic duress since March of 2010. It has caused increasing costs, broken websites, rationing of health care, higher premiums, reduced competition and resulted in fewer choices. Free market reforms by a Republican president and GOP congress can lead the effort to reform the healthcare industry.
In comparson, Clinton’s view is that Obamacare has grown by more than 14 million people since 2013 and expanded access to Medicaid for low-income people in many states. Repealing the health care law would take away benefits for those people in several states and cause further economic strife. Mr. Trump’s block grant proposal for Medicaid is still very basic and more specifics are needed to assure the public it won’t simply eat away access and benefits for the poor.