PROMISES, PROMISES: What Trump has pledged on health care
Those promises come under two big headings. First, what Trump would do about the Affordable Care Act, his predecessor's health care law, often called "Obamacare." Second, the kind of health care system that Trump envisions for Americans.
On repealing Obama's law, Trump seems to have a realistic chance to deliver. But he's nowhere close to fulfilling his generous promises of affordable health care for all.
A look at some of the president's major health care promises, and how the Republican legislation advancing in
REPEAL 'OBAMACARE'
Repealing President
Both the House and
Both bills end Obama's unpopular requirement for individuals to carry health insurance or risk fines. The legislation also phases down the Medicaid expansion and repeals hundreds of billions of dollars in taxes on upper-income people and health care industries, used under Obama to finance coverage. And it opens the way for states to seek waivers of federal health insurance requirements.
Some Republican critics on the right say the congressional bills leave other major parts of "Obamacare" in place, such as subsidies for people buying private insurance, and too many rules. While the subsidy structure would remain, much less taxpayer money is invested in it.
"INSURANCE FOR EVERYBODY"
In a
"We're going to have insurance for everybody," he said. "There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."
Trump said he was close to finishing a plan of his own that would have "lower numbers, much lower deductibles."
But the
And the congressional plans are likely to increase the number of uninsured people, because even if all Americans have access to coverage, some may no longer be able to afford it.
Deductibles are likely to rise for many people with individual coverage because the congressional plans would end subsidies under Obama's law that reduced out-of-pocket costs for those with modest incomes.
The
TAKING AWAY THE LINES
During the presidential campaign, Trump called for a system in which insurance plans would compete nationally, offering Americans choice and lower premiums.
"What I'd like to see is a private system without the artificial lines around every state," he said at one of the presidential debates.
Many experts say Trump's vision of interstate competition is unrealistic because health insurance, like real estate, reflects local prices. In any case, it remains unfulfilled in the
Some congressional leaders have promised that cross-state insurance will be addressed in follow-on legislation. Such a bill, however, would likely have to meet a 60-vote test in the
PRESCRIPTION DRUG PRICES
During the presidential campaign, and since becoming president, Trump called for action to bring down the cost of prescription drugs.
The
At one point in the campaign, Trump called for giving Medicare the authority to directly negotiate prices with drug makers, an approach favored to some extent by Obama and Democratic presidential candidate
Trump also proposed letting Americans import prescription drugs from other countries, where prices are usually lower because of government regulation.
But Medicare negotiations are a nonstarter for most congressional
MEDICAID
In a 2015 interview with The Daily Signal, Trump said: "I'm not going to cut
But last year, his campaign started backtracking on the Medicaid promise, endorsing the idea of limited federal financing for the federal-state program that covers some 70 million low-income people, from newborns to elderly nursing home residents, from special-needs kids to part-time workers lacking job-based health insurance.
The Republican bills in
Several Republican governors have joined their Democratic counterparts calling that a massive cost-shift to the states.
OPIOID CRISIS
The
"The president is all in," health secretary
But state officials say rolling back Obama's Medicaid expansion would deal a heavy blow to their efforts to treat addiction and get its victims back to jobs and family. Among the group of low-income adults made eligible for Medicaid under Obama are many younger people struggling with drug problems. They've been able to get treatment and support services through Medicaid.
The
An occasional look at the promises public officials make _ and how well they keep them
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