Republican Party Presidential candidate Donald Trump finally has made public his plan for eliminating and replacing Obamacare. His plan consists of the following seven points:
- Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
- Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
- Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
- Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
- Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
- Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
- Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.
The first point seems confusing. Repealing Obamacare would include elimination of the Individual Mandate. However, would simply repealing the IM satisfy this candidate on this point? The rest of Obamacare is damaging enough separately from the IM.
The second point seems internally inconsistent. A plan that complies with one state’s requirements won’t necessarily comply with another state’s requirements, and so that plan could not be sold in both states. This failure, though, does not prevent a vendor from offering insurance in any state; there are a plethora of vendors—UnitedHealth, Blue Cross/Blue Shield, Aetna, for instance—already sell health coverage plans in any state; they just don’t sell the same plan across state lines.
Regarding his sixth point, I’d add the requirement that those block grants be reduced by 10% of the first year’s grant (which would be taken as the baseline grant for a given state) every year until the grants reach zero. Simply block granting is a good start, though.
On the whole, the plan is based on free market principles, as Trump claims on his Web site. Subject to clarifying the two points of confusion, this outline looks like a good start to a candidate debate on competing health care reform plans. Marco Rubio has a somewhat less specific, but generally market-oriented plan, and John Kasich has one that’s centered on the health care and health cost coverage providers. The three plans should be explored in detail in the coming debates. The outcome then would form the core of a useful Congressional debate in the coming term about how to reform and salvage the health provision and health cost coverage industries that have been so heavily damaged by the Democratic Party and its Obamacare.