Dismantling Obamacare: What Has Trump Done And Who Will It Affect
The president took two decisions expanding access to cheaper, skimpier insurance and scrapping federal subsidies that may transform healthcare
Donald Trump took two extraordinary steps to undo his predecessors signature health law on Thursday, measures that could fatally damage Obamacare despite the repeated failure of Republicans in Congress to repeal it.
Having expanded access to cheaper and less comprehensive insurance which experts predict will result in health plans for the sick becoming more expensive with an executive order on Thursday morning, the president issued a surprise notice that night scrapping federal subsidies underpinning the system.
Trumps actions could undermine the health marketplace millions of Americans depend on and hurt some of the USs most vulnerable people. The president spent much of his campaign issuing vague promises to replace Barack Obamas health law which expanded coverage to nearly 20 million people and he has been frustrated by his fellow Republicans inability to coalesce around a plan to do so.
After Years Of Promising His Own Health Care Plan Trump Settles For Rebranding Rather Than Repealing Obamacare
President Trump capped his fruitless four-year journey to abolish and replace the Affordable Care Act by signing an executive order Thursday that aims to enshrine the laws most popular feature while pivoting away from a broader effort to overhaul the nations health insurance system.
The order declares it is the policy of the United States for people with preexisting health conditions to be protected, avoiding the thorny details of how to ensure such protections without either leaving the ACA, or Obamacare, in place or crafting new comprehensive legislation.
Trump announced the move during a trip to North Carolina, outlining his vision for revamping parts of the nations health care. During the speech, which came shortly before a campaign swing to Florida, Trump barely veiled the political nature of his intent.
The historic action Im taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions, Trump said, despite the fact such protections are already enshrined in law. Were making that official. Were putting it down in a stamp, because our opponents, the Democrats, like to constantly talk about it.
Health care, long a top issue for voters, has taken on fresh urgency with less than five weeks to go before the November election.
Why Do Conservatives Oppose The Law
Republicans say it imposes too many costs and regulations on business, with many describing it as a “job killer”. However, since the implementation of Obamacare jobs in the healthcare sector, at least, rose by 9% and a 2017 study found that around 2.6 million jobs could be lost by 2019 if it is repealed.
Conservatives have also baulked at Obamacare’s rule requiring most companies to cover birth control for free.
The Trump administration tried to put in place new guidelines for organisations to opt out on moral grounds last year, but two federal judges blocked the move.
During the Obama presidency, the Republican-controlled House of Representatives took dozens of symbolic votes to repeal the law and provoked a partial government shutdown over the issue.
After repeated legal challenges, in 2012 the US Supreme Court declared Obamacare constitutional.
Despite having a majority on Capitol Hill under President Trump, a Republican repeal bid failed in dramatic fashion in 2018.
Democratic leaders have acknowledged Obamacare is not perfect, and have challenged Republicans to work with them to fix its flaws.
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Who Will This Affect
The poor, the sick, older Americans, women and possibly small business owners will all be affected by Trumps moves, according to doctors. About 12.7 million people rely on health insurance marketplaces created by Obamacare.
A joint statement from six physicians groups said Trumps executive order on low-cost plans would probably cause significant economic harm to women and older, sicker Americans who stand to face higher-cost and fewer insurance options.
Democrats said the actions could cause serious, structural damage to American healthcare. Democratic congressional leaders Senator Chuck Schumer and Representative Nancy Pelosi called his actions a, spiteful act of vast, pointless sabotage, in a joint statement.
And the Republican senator Susan Collins, whose vote helped doom Republican repeal plans, said she was very concerned that Trump had ended an important subsidy that helps very low income people.
Expanding Oil Drilling In The Atlantic & Arctic Oceans
In April, Trump announced his plan to reverse Obama’s ban on oil drilling in parts of the Atlantic and Arctic oceans, a move the oil industry was no doubt appreciative of. Obama had blocked drilling in those areas shortly following the outcome of the 2016 election, in a move viewed as an effort to curtail Trump’s ability to expand offshore drilling.
But despite Trump’s order, it could reportedly take years for such operations to really begin in earnest.
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Trump Administration Allows Georgia To Quit Healthcaregov Exchange
Georgia left without having its own, state-based market a first.
Critics insist the new rule would actually do the opposite of what CMS claims, diminishing enrollment and increasing customer costs while raising the likelihood that individuals and families end up in substandard plans that leave them with gaps in coverage in the event of illness or injury.
Allowing states to privatize the ACA by eliminating any public marketplace would likely reduce overall enrollment and would surely lead to massive disruption and consumer confusion, said Joel Ario, managing director with the consulting firm Manatt Health and former director of the Office of Health Insurance Exchanges in Obamas Department of Health and Human Services.
The Georgia Department of Community Health, whose plan is the model for CMSs proposed rule, claimed in an email that the change will lead to “improved access, affordability and quality of healthcare statewide.
Opponents insist that under the new plan, Georgians will end up losing coverage and find health insurance less affordable and comprehensive.
While analysts say the incoming Biden administration could block the national rule, Itll distract from other policies and guidelines at a time when the administration should be giving full attention to the COVID-19 pandemic, said Yvette Fontenot, a former Obama health adviser.
Trump Signs Executive Order On Obamacare Impact Unclear
On his first day in office, President Donald Trump signed an executive order that gave federal agencies broad authority to defer or delay any part of the Affordable Care Act that costs anybody any money.
More formally, the order tells agencies they can “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”
That’s a mouthful, but what does it mean, and how far does it go to repeal Obamacare?
Larry Levitt, senior vice-president at the respected and neutral Kaiser Family Foundation, said in a series of tweets that while the impacts are unclear, it shows the administration is “moving to unwind the Affordable Care Act, but it won’t be immediate.”
Levitt added, “One sure outcome is it creates uncertainty for insurers at a critical time.”
Health care analyst Sabrina Corlette at Georgetown University echoed Levitt’s point.
“For insurers already uncertain about their future in the Affordable Care markets, the uncertainty this executive order generates doesn’t help,” Corlette said. “At a minimum they’ll have to factor it into their 2018 premiums, which are due to be filed by May 3 in most states.”
But that hasn’t happened yet.
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Gridlock In House Stalls Trump’s Pledge To Repeal Obamacare
As a candidate for president, Donald Trump said that “real change begins with immediately repealing and replacing the disaster known as Obamacare.”
On March 24, the nation learned that it’s not happening immediately. And the road forward isn’t clear either.
Capping a frenzied week of negotiations between three House Republican factions — the party leadership, the hardline conservative House Freedom Caucus, and members of the more moderate, pragmatic wing of the party — House Speaker Paul Ryan, R-Wis., announced that he would not bring the American Health Care Act to the floor for a vote, as he had planned.
That March 24 announcement came one day after the floor vote had been pushed back to allow for last-minute changes and arm-twisting, and half a day after Trump had issued an ultimatum to House Republicans — pass the bill or he’ll move on.
In the run-up to Ryan’s announcement, vote counting by media outlets had concluded that the House GOP would lose too many votes to pass the bill if it tried.
“We came really close today, but we came up short,” Ryan said at a press conference. “I will not sugarcoat this. This was a disappointing day for us.”
For members on the party’s right flank, the American Health Care Act left in place too much of the infrastructure of the Affordable Care Act, President Barack Obama’s signature health care law and the target of intense Republican opposition for seven years.
Millions Of Americans Lost Coverage Before And During The Pandemic
Since President Trump took office, millions of Americans have lost health insurance coverage. The number of uninsured Americans rose by 2.3 million from 2016 to 2019, including 726,000 children, according to the U.S. Census Bureau. Among the 41 states with increases in their numbers of uninsured residents, the largest increases were in Texas and Florida . Many smaller states, such as Michigan and Wisconsin , saw increases in the tens of thousands. Just a handful of states experienced a net gain in coverage, including New York, where the number of uninsured people declined by 176,000.
The increase in the number of uninsured people over the past few years is the product of Trump administration policies aimed at attacking the ACA, including signing the repeal of the ACAs individual mandate penalty and making it more difficult for Americans to obtain comprehensive insurance coverage. According to the Congressional Budget Office, Increases in health insurance premiums and the elimination of the individual mandate penalty have contributed to the rise in the uninsurance rate.
During the pandemic, the consequences of ACA repeal will be even graver: More than 20 million people overall could now lose coverage, as people shift from employment-based plans to coverage options made possible by the ACA, such as expanded Medicaid and nongroup coverage, after being laid off by an employer or losing income this year.
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Sabotage Watch: Tracking Efforts To Undermine The Aca
President Trump said that, politically, the best thing to do would be to let the Affordable Care Act explode. This timeline tracked Trump Administration actions to sabotage the ACA by destabilizing private insurance markets or reversing the laws historic gains in health coverage.
For a graphic summarizing administration actions against the Affordable Care Act,
Shortly after President Trumps inauguration, he issues an executive order directing federal agencies to use their administrative powers begin dismantling the Affordable Care Act to the maximum extent permitted by law. The order instructs agencies, for example, to do what they can to grant exemptions or delay implementation of ACA provisions that impose a tax, fee, or other costs and to encourage development of a free and open market in health care services among states, while Congress works to pass repeal legislation.
The Administration announces that it will stop planned ads for the final week of open enrollment for marketplace health coverage.
After running ahead of 2016 enrollment totals through mid-January, final 2017 HealthCare.gov plan selections come in slightly below 2016.
Administrations first health care rule is billed as market stabilization, but would discourage enrollment and undermine market stability by making plans less affordable.
|Health Plan Benefit, Rate Review, Management, and Oversight||51|
Mexico City Abortion Policy
This one isn’t unique to the Trump administration or the Obama administration â federal policy historically tends to change whenever a new party takes over the executive branch. The so-called “Mexico City” rule bans federal funding to non-governmental organizations that counsel, advise, or encourage countries or individuals to expand access to abortion Trump reinstated it upon taking office, after it was suspended for eight years under Obama.
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Fact Check: Who’s Right About Protections For Pre
After that, the president and his administration shifted to a piecemeal approach as they tried to take apart the ACA. “ObamaCare is a broken mess,” the president tweeted in the fall of 2017, after repeal in Congress had failed. “Piece by piece, we will now begin the process of giving America the great HealthCare it deserves!”
Two years later, what has his administration done to change the ACA, and who’s been affected? Below are five of the biggest changes to the federal health law under President Trump.
Plastic Bottle Ban In National Parks
The Trump administration also reversed a ban on plastic water bottles in national parks, an Obama policy that had been a wild success from the perspective of cutting plastic waste. According to The Guardian, the ban had saved more than two million such bottles, but that didn’t stop the Trump administration from rescinding it.
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How Donald Trump Is Radically Reforming Obamacare
FILE – In this Nov. 29, 2018, file photo, President Donald Trump talks with reporters before… traveling to the G20 Summit in Buenos Aires, on the South Lawn of the White House, in Washington. Trump complained Monday, Dec. 3, 2018, about how much the U.S. spends on weapons in an uncontrollable arms race with Russia and China, though he vastly overstated how much is spent on actual armaments as part of a budget his administration has increased.
In the face of congressional inaction, the Trump administration has set out to reform Obamacare by executive order. The reforms stretch the boundaries of what many thought was possible without an act of Congress. Although some changes are still in the comment period , the Trump reforms in some ways are more radical than Obamacare itself.
Personal and portable health insurance. The United States has a long history of encouraging health insurance at the place of work. Premiums paid by employers avoid federal and state income taxes as well as the Social Security payroll tax. By contrast, unless they get Obamacare subsidies, most Americans receive no tax relief if they buy health insurance on their own.
Given the sorry state of the individual market in most places, why would employers and their employees find this option attractive? Because of other Trump reforms.
Ill have more to say about these policy changes in future posts.