GOP Plan for Obamacare Finally Clear

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Health care was largely out of the picture during the presidential campaign. That changed last week when Donald Trump answered questions about his health during the presidential debate. Intentions for the Affordable Care Act (aka Obamacare).

Trump claimed he “saved” the 2010 health care law despite trying to repeal it in his first year as president. He then promised he had “a concept for a plan” to replace it.

Trump did not specify what these concepts were. There is nothing new. The Republican presidential candidate has been promising a mythical and never-defined plan to provide “great health care at a fraction of the cost” since he first talked about repealing Obamacare during the 2016 campaign.

But over the weekend, his running mate, Ohio Sen. J.D. Vance, said Trump actually has an alternative. figure On NBC’s “Meet the Press,” Vance said Trump has in mind a “deregulatory agenda so people can choose the health care plan that’s right for them.”

Vance explained that because Americans have different health care needs, “it makes sense to encourage more choice in our health care system and not take a one-size-fits-all approach that throws a lot of people into the same insurance pool, the same risk pool. That actually makes it harder for people to make the right choices for their families.”

Among us follow health care policy He immediately understood what he was talking about.

At any given time, most people are in relatively good health and therefore do not spend much on health care. Most of the costs are incurred by the few who receive intensive or ongoing treatment for serious health problems (basically anything from car accidents to diabetes to cancer).

The challenge for health policy is how to cover these huge costs. The approach in most economically developed countries (and included in programs like the Affordable Care Act) is to have everyone contribute to an insurance fund so that the healthy can help the sick. This is the “insurance pool” and “risk pool” that Vance criticizes.

Another alternative would be to allow more segregation based on health status, for example, allowing insurers to charge higher prices, withhold certain benefits, or deny coverage altogether to people with preexisting conditions.

This may work well for healthy people, at least in the short term, because they will be comfortable buying a basic plan that the insurance company charges less for. But if they do eventually need serious medical care, as most people eventually do, they will likely run into problems because their insurance will not cover their needs.

And that’s not to mention the people who already have serious health problems but never found insurance in the first place.

This is how many Americans do things. ~ before Obamacare, and that’s just how it works. yet again An alternative to the Affordable Care Act that conservatives have advocated in the past.

Vance was careful to say that he and Trump would “make sure everyone is covered,” as Trump had previously promised. But the actual plan that Republicans put forth in their 2017 repeal fight would have increased the number of uninsured Americans by millions or even millions. Tens of millions, Partly because it failed to protect people with pre-existing conditions, and partly because it proposed cutting funding for Medicaid, the insurance program for low-income Americans.

And that’s not surprising. Conservatives don’t just want to reduce the cross-subsidies between healthy and sick people. They also want to free up money for tax cuts that disproportionately benefit the wealthy. Trump and the Republicans I still want to do it.

Of course, cutting health care programs for tax cuts is not particularly popular. Nor is undermining protections for people with pre-existing conditions. Republicans know this all too well. The 2017 repeal effort political disaster That’s all they had, so they don’t bother talking about it these days.

But that doesn’t mean they’ve given up or that they can’t rally votes if they retake Washington. Consider the comments made by Republican House candidates in key swing states over the summer.

Candidate Allison Esposito is running in New York’s 18th Congressional District. Like most Republicans on the ballot this year, she didn’t have much to say about health care. But according to recordings provided to HuffPost by a source, the topic was raised twice during a campaign event over the summer.

The first came at a local conservative party conference in July, where an audience member noted that Trump had posted on social media last fall that Republicans should “never give up” on trying to “end” the Affordable Care Act and that if he were to run for a new term, he would replace it with a “better” alternative that was not yet specified.

“I wonder if that’s something you support, or if you can say something,” the audience member said.

Esposito responded, “Well, yes, we need to have a better health care system.” She later said, “Obamacare doesn’t work.”

The Affordable Care Act isn’t the only Democratic health care reform bill that has drawn Republican ire. Another The Inflation Reduction Act, the Climate and Health Care Act of 2022 is a wide-ranging piece of legislation. Among its provisions are a series of initiatives, including: Medicare lowers drug costs For example, it would cap the cost of insulin at $35 per month and allow the federal government to: Bargain The price of some expensive drugs.

The second time Esposito was asked about the program’s future, this time at an electronic town hall in August. “Would you vote to repeal the inflation reduction law?” the questioner asked Esposito.

“Yes,” she replied. “That was reckless, and (Vice President) Kamala Harris played a pivotal role in printing money and investing in our system and our budget in a way that was irresponsible and reckless.”

To be clear, the question wasn’t that specific, and Esposito’s answer was certainly open to interpretation. Did she really intend to support repealing the Affordable Care Act? Did she really want to repeal the Inflation Reduction Act’s prescription drug reforms?

But when The Huffington Post asked her campaign directly, a spokesperson’s response was to lament high health care costs, attack Biden for undermining parts of Medicare, and promise that Esposito would “find a way for everyone to find the health care coverage that works best for them and their families.”

What was noticeably absent from the statement was a denial that Esposito wanted to reform drug prices or repeal Obamacare, both of which the district’s Democratic incumbent, Pat Ryan, has supported. Esposito may not be willing to lead a crusade against either program, but other Republicans might be.

Project 2025The Heritage Foundation’s Trump 2-Term Agenda calls for repealing both drug pricing reform and key provisions of the Affordable Care Act, including the latest budget. Republican Study CommitteeA group representing conservatives in the U.S. House of Representatives.

And this week, Axios article Two prominent Republican lawmakers were quoted as saying they would try to kill new drug pricing reforms, an effort that would undoubtedly have strong outside support from the pharmaceutical industry.

The logic here is no mystery. Conservatives believe that lowering drug prices will ultimately stifle innovation, just as they believe that the Affordable Care Act’s rules make insurance markets less efficient. This is part of a broader belief that federal intervention in health care ultimately does more harm than good.

And Trump? He hasn’t said specifically what he thinks about drug price changes. When Axios asked the campaign for his position, a spokesperson responded with a cliche that Trump “will be more forthcoming with details, but his overall position on health care remains the same: improving competition in the marketplace to lower costs and improve quality of care.”

That’s exactly the response we got when HuffPost asked the Trump campaign to clarify its position on Medicaid last week, and it’s very similar to what Esposito said when asked to clarify his position over the summer: When given the chance to defend the program, they refused. That speaks volumes.