A YEAR OF TRUMP: President Trump’s War on Americans’ Health Care: More Broken Promises to the Middle Class

From the House Democratic Leader's Press Office

Press Banner State of the Union 2018 (002)

President Trump's War on Americans' Health Care: More Broken Promises to the Middle Class

President Trump Promised to Replace the ACA With A "Better" System: Throughout the first several months of 2017, President Trump promised that, in replacing the Affordable Care Act, he would create a better health care system--with lower health care costs for families, "insurance for everybody," fully protecting pre-existing conditions, and "making all groups better off."

However, the American People Discovered that the "Trumpcare" Bill Would Make the Health Care System Worse - Breaking Every Single One of The President's Promises: As Americans learned, Trumpcare would result in higher health care costs for families, 23 million more uninsured Americans, an "age tax" that would leave Americans ages 50-64 much worse off, and taking away the protections for Americans with pre-existing medical conditions.

While the Trumpcare Effort Has Currently Collapsed, Trump Is Continuing to Work to Sabotage Americans' Health Care, Increasing Americans' Premiums and Reducing Choices: President Trump has been playing politics with Americans' health care - including taking steps to depress enrollment in the Marketplaces. He is also working to allow insurers to once again sell 'junk insurance.'

President Trump Has Also Broken Promises Not to Cut Medicaid and to Focus on Battling the Opioid Epidemic: President Trump had promised never to cut Medicaid, but his budget proposed a cut of $1.4 trillion. Likewise, Trump has broken his promise to focus on the opioid crisis.

PRESIDENT TRUMP SPENT MONTHS FIGHTING FOR TRUMPCARE, WHICH WOULD HAVE RAISED FAMILIES' HEALTH CARE COSTS, REDUCED COVERAGE, AND UNDERMINED PROTECTIONS FOR PRE-EXISTING CONDITIONS

Here are some of the devastating consequences of Trumpcare, if it had been enacted:

*Higher Costs: Trumpcare would force families to pay higher deductibles and other out-of-pocket health care costs. In particular, Trumpcare would force older Americans and sicker Americans to pay substantially higher out-of-pocket costs.

*Less Coverage: According to the nonpartisan CBO, Trumpcare would result in 23 million Americans losing their health care coverage over the next 10 years.

*Key Protections Gutted: Trumpcare would gut Essential Health Benefits and protections for Americans with pre-existing conditions, for millions of Americans.

*A Crushing Age Tax: Trumpcare would force Americans aged 50-64 to pay premiums five times higher than what others pay for health coverage, no matter how healthy they are. Due to the Age Tax and inadequate premium tax credits, CBO estimated that, under Trumpcare, a 64-year-old with an income of $26,500 in the individual market would pay $14,400 more in their premiums each year - an increase of 850 percent.

*Steals from Medicare: Trumpcare would steal $75 billion from the Medicare Trust Fund, shortening the life of the Medicare Trust Fund. Trumpcare would also ransack funds that that seniors depend on to get the long-term care they need.

Due to its numerous devastating consequences, the American public strongly rejected Trumpcare: Polls showed that the American people opposed the Trumpcare legislation by a margin of 2 to 1. For example, a Public Policy Polling poll found that 52 percent of Americans opposed Trumpcare, with only 25 percent supporting it.

SINCE HIS FIRST DAYS IN OFFICE, PRESIDENT TRUMP HAS ALSO BEEN WORKING TO CYNICALLY SABOTAGE AMERICANS' HEALTH CARE - WITH HIS SABOTAGE INCREASING PREMIUMS AND REDUCING CHOICES

Here are just some of the actions that President Trump has taken to sabotage Americans' health care and the ACA Marketplaces - working to destabilize the Marketplaces and raise people's premiums. He has appeared to be discouraging people from enrolling in the Marketplaces - which directly results in higher premiums for those who do enroll:

*To Depress Enrollment, Slashed the Open Enrollment Period for ACA Marketplaces in Half: President Trump has taken steps clearly designed to make it more difficult to enroll in the Marketplaces. In the previous Open Enrollment periods, Americans had three months to sign up - President Trump cut that to six weeks.

*To Depress Enrollment, Slashed Outreach and Advertising Efforts, As Well As Funding for Navigators: President Trump slashed by 90 percent the budget for the advertising designed to ensure consumers had the information about the Marketplaces they needed. He also slashed by 41 percent funding for Navigators, who reach out particularly to the uninsured to increase their awareness of the Marketplaces and assist with enrollment.

*Has Used Rhetoric to Depress Enrollment and Destabilize the Marketplaces: Ever since the beginning of his Presidency, Trump has appeared to be cheering for the collapse of the Marketplaces - constantly saying "Obamacare is dead" and "the best thing we can do... is let Obamacare explode."

*Spent Months Raising Doubts He Would Continue Key ACA Payments, and Then Suddenly Eliminated the Payments in October. On October 12, President Trump suddenly announced he was stopping federal Cost Sharing Reduction payments that help reduce out-of-pocket costs for individuals. According to CBO, https://www.cbpp.org/blog/cbo-severe-harm-if-trump-halts-health-cost-sharing-payments this action by the President increased Marketplace premiums by 20 percent in 2018 and by 25 percent in 2020. In addition, CBO estimates that this step will increase the costs to the U.S. taxpayer by a total of $194 billion over the next 10 years. (Since premiums went up dramatically because of this action, premium tax credits went up too, thereby increasing taxpayers' costs.)

*Worked with Republicans to Include the Individual Mandate Repeal in GOP Tax Scam Bill, Which Will Result in A Spike in Premiums and 13 Million Fewer People Insured: According to the nonpartisan CBO, https://www.cbo.gov/system/files/115th-congress-2017-2018/reports/53300-individualmandate.pdf the repeal of the individual mandate, which becomes effective in 2019, would result in 13 million fewer Americans having health insurance and a spike in premiums, with premiums increasing by 10 percent in most years of the decade. The repeal of the individual mandate will also result in people with pre-existing conditions having to pay more for their health coverage.

*On January 4, 2018, Put Forward A Proposed Rule That Would Once Again Allow Insurers to Sell 'Junk Insurance,' Further Sabotaging Americans' Health Care: On January 4, President Trump put forward a proposed rule to expand so-called "association health plans." The rule would allow associations to create junk plans that provide fewer protections and less coverage. By allowing association health plans to skirt consumer protections and sell products that don't offer critical benefits, the rule will put individuals with pre-existing conditions at risk of losing the coverage they need.

*Despite All of President Trump's Sabotage, the Affordable Care Act Is Still Standing Tall: Despite the sabotage, because of Americans' continuing demand for affordable, quality health coverage, enrollment in Healthcare.gov for 2018 is only slightly below last year's, and enrollment in the various state-based Marketplaces is either roughly the same or above last year's. Republicans should be working with Democrats to help make improvements in the Affordable Care Act, bringing down costs and expanding coverage, and give up their efforts to repeal it.

PRESIDENT TRUMP'S FY 2018 BUDGET BROKE ANOTHER OF HIS PROMISES, BY PROPOSING SLASHING MEDICAID BY $1.4 TRILLION, HURTING SENIORS AND MILLIONS OF HARD-WORKING AMERICANS

*At Various Times During the Campaign, Trump Promised He Would Not Cut Medicaid. For example, on May 21, 2015, one month before he officially launched his campaign for president, Trump made the following promise when talking to the conservative Daily Signal, "I'm not going to cut Social Security like every other Republican and I'm not going to cut Medicare or Medicaid. Every other Republican is going to cut." [Daily Signal, 5/21/2015]

*Yet, In May 2017, President Trump Broke This Promise When He Finally Unveiled His FY 2018 Budget, Proposing $1.4 Trillion in Cuts in Medicaid. On May 23, 2017, President Trump unveiled his full FY 2018 budget, proposing gutting Medicaid by cutting it by a total of $1.4 trillion, while at the same time slashing taxes for the wealthiest and large corporations. First, the Trump budget called for the enactment of the House-passed GOP bill to repeal and replace the ACA, which by repealing the expansion of Medicaid, would result in slashing Medicaid by $800 billion. Secondly, the Trump budget cut an additional $610 billion from Medicaid, which would fall on seniors in nursing homes, children with disabilities, and low-income families in cash-strapped states looking to reduce services or drop people from coverage altogether.

FINALLY, PRESIDENT TRUMP HAS ALSO BROKEN HIS PROMISE TO TARGET NEW RESOURCES ON FIGHTING THE OPIOID EPIDEMIC

*During the Campaign, Trump Promised to Make Battling the Opioid Crisis A Priority: In Ohio, Trump promised, "We're going to take all of these people that are totally addicted... We're going to spend the money. We're going to get that habit broken." In New Hampshire, he promised, "We have to solve the crisis."

*"Opioid Epidemic 'Getting Worse Instead of Better'; Public Health Officials Warn" [USA Today, 10/5/17]: The number of deaths from opioid overdoses jumped by 39 percent in 2016 - from 35,890 in 2015 to 50,018 in 2016. Indeed, opioids killed more people in 2016 than the 37,400 killed in car accidents or the 40,000 who died from breast cancer. And yet the Trump Administration has failed to convey a sense of urgency about the crisis. Indeed, at a Capitol Hill hearing on October 5, public health officials testified that, in 2017, the epidemic continued to get worse instead of better.

*"Trump Declares Opioid Crisis a 'Health Emergency' But Requests No Funds" [NYT, 10/26/17] As the NYT reports, "President Trump on [Oct. 26] directed the Department of Health and Human Services to declare the opioid crisis a public health emergency...His directive does not on its own release any additional funds... and the President didn't request any."

*Public Health Experts Say that New Resources Are Urgently Needed: Andrew Kolodny, co-director of opioid policy research at Brandeis, stated, "What we need is for the president to seek an appropriation from Congress, I believe in the billions, so that we can rapidly expand access for effective outpatient opioid addiction treatments. Until those treatments are easier to access than heroin or fentanyl, overdose deaths will remain at record-high levels."