President Trumps Record On Health Care
Since taking office, President Trump has laid down an extensive record on health care, beginning on day one with his clearly-stated intention to repeal and replace the Affordable Care Act, and continuing through his most recent response to the COVID-19 pandemic. In addition, the Trump Administration has made or proposed many changes to health policies and programs that could have a significant impact on health coverage and health care.
President Trumps record on health care illustrates his priorities. An incumbent presidents record is always relevant, but especially so for President Trump, who has not released more conventional campaign policy proposals. Moreover, the Presidents response to the COVID-19 crisis, and its economic consequences could influence how voters view the president in terms of his character, his leadership and his ability to protect the nation particularly given widespread and ongoing transmission of the virus in the U.S. and evidence that the U.S. has fared relatively poorly compared to peer nations.
Column: Trump Makes Good On A Threat To Kill Teen Pregnancy Prevention Programs
Experts in teen pregnancy prevention were nervously holding their breaths as the Trump administration stocked key positions at the Department of Health and Human Services with advocates of ineffective abstinence-only sex education programs and opponents of birth control.
The cutoff was the handiwork of a cadre of anti-abortion activists placed into high offices at HHS. One has promoted the claim that abortion increases a womans chance of breast cancer and of serious mental health problems, which is unsupported by medical science. Another treated anti-pregnancy education as a matter of morals, not empirical data. As public health experts and policymakers, we must normalize sexual delay more than we normalize teen sex, even with contraception, she said. But studies consistently show that what reduces teen pregnancies is increased use of contraceptives.
No. 5: Work rules for Medicaid. The administration has gone full speed ahead on allowing states to impose work rules on residents enrolling in Medicaid, the program aimed at bringing health coverage to the poor. Thats happening despite clear evidence that the rules are catastrophic for the target populations health coverage and do nothing to increase employment or produce job opportunities.
Reformed Medicare Program To Stop Hospitals From Overcharging Low
Its true that the Trump administration changed the rules for how Medicare pays for prescription drugs through the 340B program, lowering the rate that hospitals are reimbursed for drugs, which in some cases lowers co-payments for seniors, according to the Kaiser Family Foundation. It is not clear how much seniors have saved through this change.
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Contrary To His Promises Trump Has Increased Health Care Costs
Marketplace enrollees and taxpayers are paying the cost of the Trump administrations ACA sabotage. Policies that draw healthier people away from comprehensive coverage leave those remaining in the risk pool with higher premiums. The Congressional Budget Office estimated in 2018 that Congress repeal of the ACAs individual mandate would not only result in 1 million fewer people insured that year but would also drive individual premiums higher than they would have otherwise been starting in 2019.
In its analysis of rate filings for 2019, the Kaiser Family Foundation estimated that plans added an average of 6 percent to premiums to account for the mandate repeal and the Trump administrations promotion of junk plans. The repeal of the mandate has lasting effects. That extra 6 percent on 2020 premiums means that the average HealthCare.gov marketplace premium$7,140 annuallyis $404 higher than it would be without ACA sabotage.
The Trump administration has meddled with marketplace premiums in less transparent ways as well. Since 2019, insurance plans have been able to raise their premiums up to 15 percent each year without explanation because the Trump administration lifted the ACAs threshold for federal rate review from its previous 10 percent.
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.
Table 1
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.
Figure 1
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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Column: Health Secretary Azars Attacks On Obamacare Make Him Trumps Most Dangerous Cabinet Member
The contest for worst Cabinet member of the Trump administration is what we might call competitive.
You propose implementing mandatory work requirements for Medicaid beneficiaries not knowing what the impact will be, across every single state. Whats the logic in that? Azar was asked by Rep. Joseph P. Kennedy III . Azar didnt have a cogent answer.
No. 8: Deliberately raising ACA premiums for 7.3 million people. In April, the administration issued a final rule for marketplace plans in 2020 that it acknowledged would raise premiums for 7.3 million consumers by cutting their premium subsidies. The administration conceded that the higher premiums would cause 70,000 people to drop marketplace coverage each year. The Center on Budget and Policy Priorities calculated that the change would cost a family of four with income of $80,000 an additional $208 annually.
The CBPP observed that the change was not required by the ACA or any other law. The administration is making an entirely discretionary choice to raise costs for millions of people, just weeks after President Trump justified his latest efforts to repeal the ACA by arguing that it has resulted in premiums and deductibles that are too high. In its explanation of the rule, the administration said it would move forward even though, in its own words, all commenters on this topic expressed opposition to or concerns about the proposed change.
What The Data Reveals
Dr. Andrew Bindman, a professor of medicine, epidemiology, and biostatistics and a core faculty member at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco, told Healthline that the Trump administration has made it an explicit goal from day one to undermine the ACA.
While President Trump failed to deliver on his promise to overturn the ACA, he has done all he could without the approval of Congress to sabotage the law, Bindman said.
Unlike President Obama, who focused on expanded coverage, President Trumps legacy is a decline in healthcare coverage, leaving Americans less protected during a pandemic when the security of healthcare coverage is more important than ever, he said.
Bindman knows a lot about the ACA since he was one of the people who helped draft it. He made his contributions to the legislation when he served as a health policy fellow on the staff of the House Energy and Commerce Committee.
Like Bindman, John McDonough, DrPH, MPA, a professor of public health practice in the department of health policy and management at the Harvard T.H. Chan School of Public Health and director of executive and continuing professional education, is another person intimately familiar with the healthcare plan.
He worked on the development and passage of the ACA while a senior adviser on national health reform to the Senate Committee on Health, Education, Labor, and Pensions.
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Health Reform Monitorhealth Reforms In The United States: The Outlook After Biden’s First 100 Days
Joe Biden immediately reversed several of Donald Trump’s health policies.
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A chief early accomplishment was raising premium subsidies to increase insurance coverage.
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Future items include enacting a public insurance option and reducing drug costs.
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Most key reforms require legislative success in an exceedingly difficult political environment.
Yes Trump Has A Health Care Plan He Has Been Implementing It
Joe Bidens assertion during Tuesdays debate that President Trump does not have a health care plan is flat out false.
Unfortunately, the mainstream news medias fact checkers probably wont call him out on it, and not just because of their normal anti-Trump bias. In fact, there is a widespread misunderstanding of what the president has done in health care and how it all fits together.
Back in 2018, we described President Trumps 1,000 step progress on health reform, noting that instead of opting to pass one giant, comprehensive health care bill, the president was delivering a series of small but significant reforms to cumulatively take us to a much better destination.
That destination was outlined in 2017 by the administration in a 124-page Health and Human Services document, Reforming Americas Healthcare System Through Choice and Competition. The document is a distillation of the dysfunction of our health care system, much of which ObamaCare made worse. It also paints a picture of an alternative model one that puts patients before insurance companies or government bureaucrats and delivers better care and coverage at lower costs.
Everything that President Trump has done in health care since then has been consistent with the vision laid out in the document. The challenge for the news media, and even some of the presidents supporters, has been an issue of attention span a tendency to miss the forest for the trees.
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Vice President Mike Pence
Pence on healthcare
- The Trump campaign released a statement on November 14, 2016, detailing what Pence discussed at the Republican Governors Association Annual Conference. At the event, Pence “reiterated…Trumps strong commitment to repeal and replace Obamacare and block grant Medicaid funding to state governments to encourage innovation that better delivers healthcare to eligible residents.”
Pence on the AHCA
- On June 3, 2017, Pence urged members of Congress to pass the American Health Care Act of 2017 during a political rally in Iowa. He said, “First and foremost, this summer, this Congress must come together and heed the president’s leadership, and we must repeal and replace Obamacare. … Once we repeal and replace Obamacare, we’re going to roll our sleeves up, and working with these great leaders in Congress, we’re going to pass one of the largest tax cuts in American history.”
- On May 4, 2017, after the House passed the AHCA, Pence said, “It was March, 2010, seven years ago, Democrats passed a government takeover of healthcare. And at that time, Republicans in Congress promised the American people that law would not stand. Today, thanks to the perseverance, the determination, and the leadership of President Donald Trump, and all the support of those gathered here, weve taken a historic first step to repeal and replace Obamacare and finally give the American people the kind of healthcare they deserve.”
Pence on the ACA
Nato Allies Increased Their Defense Spending Because Of His Pressure Campaign
True. Although NATO countries were already modestly increasing their military spending before Mr. Trump took office, there is evidence that his public complaints led to a deal that allowed the United States to decrease its own spending, while some other countries increased their share each year that he has been in office.
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Accomplishment: Defeating Isis’s Caliphate And Killing Abu Bakr Al
ISIS shocked the world in 2014 when it took over a large swath of territory across Iraq and Syria and declared a caliphate.
The terrorist group’s territorial holdings were the basis for its so-called caliphate, and provided it will a major base of operations to conduct attacks across the world.
After a five-year effort led by the US, ISIS’s caliphate was finally defeated in March 2019.
Trump at times falsely claimed that ISIS is totally defeated, embellishing the extent of the US military’s success against the terrorist organization during his presidency. Though the terrorist group has lost its territory its so-called caliphate it’s still estimated to have up to 18,000 fighters in Iraq and Syria.
In late October, a US raid led to the death of ISIS leader Abu Bakr al-Baghdadi.
Baghdadi was the world’s most wanted terrorist up to that point and his death represented a major blow to the terrorist group.
“Last night, the United States brought the world’s No. 1 terrorist leader to justice,” Trump said at the time. “Abu Bakr al-Baghdadi is dead.”
“Capturing or killing him has been the top national security priority of my administration,” he added.
Trumps Forbidden Love: Single
Washington Post, May 5, 2017
President Trump claimed a victory Thursday after the House approved a more free-market approach to health care.
Then he capped it off by praising a country with government-run, universal health care.
Alongside Australian Prime Minister Malcolm Turnbull at an event in New York, Trump reflected on what the House had just done. He took the occasion to bash Obamacare as being terrible, and then he turned to Turnbull.
We have a failing health care I shouldnt say this to our great gentleman and my friend from Australia, Trump said, as The Posts Abby Phillip reports, because you have better health care than we do.
Australias health-care system is run by the government. Its essentially a single-payer, Medicare-for-all system that is available to everyone, with private insurance also available.
Consider this merely the latest evidence that Trump, in his heart of hearts, wants single-payer health care. Indeed, it seems to be his forbidden fruit.
Back in 2000, he advocated for it as both a potential Reform Party presidential candidate and in his book, The America We Deserve.
We must have universal health care. Just imagine the improved quality of life for our society as a whole, he wrote, adding: The Canadian-style, single-payer system in which all payments for medical care are made to a single agency helps Canadians live longer and healthier than Americans.
And some see the current debate eventually winding up with single-payer.
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The Swamp Grew Even Under President Donald Trump
The results were immediateânearly 30 new association health plans popped up in the seven months after the Department of Labor finalized the rule. Some of those plans featured premiums that cost up to 35% less than those on the Obamacare exchanges.
But the future of the association health plan rule is not clear. In 2019, the U.S. District Court for the District of Columbia invalidated the rule. The Trump administration appealed to the U.S. Court of Appeals for the D.C. Circuit, but the case has not yet been resolved.
President Trump’s team has also tried to expand access to affordable coverage for individuals. A 2018 rule issued by the administration extended the maximum duration of short-term health plans to one year, up from the Obama administration’s maximum of three months. The rule also allowed insurers to renew short-term plans for up to three years.
Short-term health plans are not subject to Obamacare’s cost-inflating mandates and regulations. So they tend to be much less expensive than the coverage available on the individual-market exchanges.
According to a 2019 study published by the Manhattan Institute, a typical short-term plan premium for a 30-year-old nonsmoker in Fulton County, Georgiaâhome to Atlantaâwas $209 a month, with a $5,000 deductible and a $7,000 out-of-pocket maximum. A comparable exchange plan, with a slightly higher deductible and out-of-pocket maximum, was $296 a month.
Healthcare Equality For Marginalized Communities
Recognizing the needs of marginalized communities due to inequalities in healthcare is an area in which the two candidates vastly differ.
The president has focused on economic opportunity as a way to support the Black community.
On Friday, he announced the Platinum Plan, a $500 billion economic plan designed to increase opportunities for Black Americans.
The plan promises better and cheaper healthcare and investments in treatments for kidney disease, diabetes, and sickle cell anemia, conditions that disproportionately affect Black communities.
Taylor criticized the Platinum Plan as a day late and a dollar short.
He is 4 years in and we have seen no comprehensive plan to address inequality for African Americans under the Trump administration. Furthermore, Trump policies have done nothing but deepen inequities for low-income people and people of color throughout this country, she said.
Taylor said that Biden, in contrast, has been consistent and clear about addressing health inequalities as well as ensuring coverage for those who have fallen into the gap.
Biden has talked about maternal mortality for women of color, ensuring mental health coverage regardless of sexual orientation, ensuring access to quality generics. The list goes on and on, Taylor said. All of these issues are essential to addressing disparities as well as the gap for folks of color.
In fact, Trump has rolled back healthcare protections for LGBTQ people, actions Biden has pledged to reverse.
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