Donald Trump’s 7-Point Healthcare Plan

March 4, 2016

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Now that his road to the Republican nomination for President seems to be getting shorter, Donald Trump has released a seven-point plan for healthcare reform. But, like much in this campaign to date, it is short on details and new ideas. In fact, what’s remarkable about the plan is what is NOT in it.

Trump’s first item is – of course – to repeal Obamacare. The billionaire goes a bit farther than he has before and specifies: “Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.” That’s likely an attempt to clear up the confusion created when, on February 29, Trump told CNN’s Anderson Cooper, “I like the mandate.” Apparently he was referencing another mandate.

Trump took another U-turn on the issue of drug prices. In January, Trump said the U.S. could save “$300 billion” by allowing Medicare to negotiate drug prices. (This was in spite of the fact that total U.S. drug spending is only slightly above that amount.)That proposal is gone. In its place: “Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products.” In the March 3 Republican debate Trump repeated his commitment to negotiating drug prices for Medicare. So it’s not clear if it’s in or it’s out.

Trump goes on to say he would allow consumers access to imported, safe and dependable drugs from “overseas” – presumably from Canada, which is actually only over a river.

As for the rest of his plan, Trump recycled several items from the Republican healthcare playlist including:

  • Allowing consumers to invest in health savings accounts (HSAs) and deduct those dollars from their taxes (something that is already allowed);
  • Allowing health insurers to sell policies across state lines as long as they comply with state rules (insurers say they can’t do that because the rules differ from state to state and consumer advocates warn of a “race to the bottom” as insurers look to locate in the state with the weakest requirements);
  • Demanding greater transparency in prices from doctors, clinics and hospitals; and
  • Turning Medicaid – now a federal entitlement program – into a state-run block grant.

The Trump campaign says these proposals are just a start. Future ideas “might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans.”

What’s missing from this plan is any mention of what would replace the Affordable Care Act once it’s repealed. On February 7, Trump said: “I don’t want people dying in the middle of the street. It’s not going to happen if I’m President.” Since 1986 the U.S. has had a law on the books prohibiting any hospital from turning away a patient in distress no matter their insurance or income status. The Emergency Medical Treatment & Labor Act was enacted by President Reagan to put an end to what were euphemistically called “economic transfers” of uninsured patients.

This certainly isn’t the last we will hear on the subject of healthcare from Trump, Hillary Clinton or the other remaining candidates. But, bit by bit, the picture is beginning to emerge.