After years of promising a replacement for ObamaCare, President Donald Trump unveiled his “America First Healthcare Plan” Thursday at an appearance in Charlotte, North Carolina. But far from replacing ObamaCare, the plan seeks to retain its most popular feature, the ban on denying health insurance to individuals with preexisting conditions, while making only modest changes to existing policies.
“Under the America First Healthcare Plan,” Trump said, “we will ensure the highest standard of care anywhere in the world, cutting-edge treatments, state-of-the-art medicine, groundbreaking cures, and true health security for you and your loved ones.”
Much of Trump’s speech, like the executive order he signed afterward, consisted of recounting his accomplishments with regard to healthcare. Some, such as repealing the individual mandate, are constitutional; others, such as grants for HIV treatment, are not.
Moreover, while Trump ran on repealing ObamaCare and supports a lawsuit to overturn it, his remarks seemed to suggest he had made peace with it. “ObamaCare,” he declared, “is no longer ObamaCare” because his administration has “managed it very well.” In fact, he said the American people can’t lose regardless of the outcome of the suit: A win would mean the end of ObamaCare, but a loss would mean the continuation of the new, improved ObamaCare.
Trump’s executive order states, “It has been and will continue to be the policy of the United States to give Americans seeking healthcare more choice, lower costs, and better care and to ensure that Americans with pre-existing conditions can obtain the insurance of their choice at affordable rates.” Few would disagree with those objectives. The arguments concern how to attain them, and on those matters, the order is silent.
Trump claimed the order was necessary because Democrats, whom he likened to “radical socialists and communists,” give lip service to protecting people with preexisting conditions, “yet preexisting conditions are much safer with us than they are with them.” Similarly, he asserted that he had “made Social Security stronger, better,” and that “as long as I’m President, no one will lay a hand on your Medicare.” In other words, vote Republican if you want efficient, well-managed socialism.
The rest of the order is similarly light on details. It directs executive branch departments to “maintain and build upon existing actions to” expand affordable healthcare options; accelerate drug approvals; facilitate importation of drugs from foreign countries; end “surprise billing” from healthcare providers; “reduce waste, fraud, and abuse”; and “promote medical innovations.”
The one directive that does offer some specifics — ending surprise billing — takes a dim view of the separation of powers. It directs the secretary of Health and Human Services to work with Congress to develop legislation to accomplish this end by December 31. If, however, no bill is passed by that date, the secretary is simply to “take administrative action” to make it happen.
The president did not waste time on details in his speech, either. His plan, he said, will “revolutionize access to telehealth,” force hospitals and insurers “to post all of their prices online,” require pharmaceutical companies to sell drugs in the United States for the lowest price they sell them in other countries, give Medicare beneficiaries $200 to buy prescription drugs, and mandate that doctors maintain electronic records for their patients. How the government will accomplish all this, let alone do so while keeping its budget under control and staying within its constitutional bounds, Trump did not say.
Trump acknowledged few possible downsides to his proposals. He did note that requiring drugs to be sold at their lowest worldwide costs could cause companies to increase their lowest prices, though he thought they would only “come up a little bit.” Meanwhile, the electronic health records he wants to force on people, also a component of ObamaCare, are driving doctors out of the profession, and they help the government control the people far more than they help people control their healthcare.
It would appear, then, that with an election looming, Trump felt the need to finally make good on his many promises to present an ObamaCare replacement. Unfortunately, his alternative consisted of a wish list of good and bad ideas with no particular plan for implementing them and little consideration of their possible consequences.
Photo: sanjeri / E+ / Getty Images Plus
Michael Tennant is a freelance writer and regular contributor to The New American.
