TrumpCare Explained

What is TrumpCare?

“TrumpCare” is Donald Trump’s healthcare reform platform, below we explain TrumpCare and how it is different than ObamaCare.

TIP: The GOP forever altered the lexicon when they called the Patient Protection and Affordable Care Act “ObamaCare”. With this in mind Trump’s healthcare plan has been dubbed “TrumpCare”.

TIP:You can see Trump’s healthcare reform to make America great again here.  See Vox’s TrumpCare article for a different take.

Overview of TrumpCare

On his website, the TrumpCare plan listed is part “a rehash of the Republican playbook (insurance over state lines, HSAs, get those sick losers out of our great healthcare system)” and part, oddly, “socially liberal market-based healthcare reform and cracking down on big phrama”.

Despite some of the typical republican playbook being included in his written plan, parts of the plan, and the words that come out of Trump’s mouth paint a very different picture.

Below I’ll tell you what Trump’s written position means for American healthcare, what his past statements would mean, and how that is different (or not ) from ObamaCare.

First, let us get a glimpse a Trump speaking his mind so we can set the stage.

“The Government’s Gonna Pay For It” – Wildcard Donald Trump on Single-ish Payer.

TIP: See how past healthcare proposals differ and relate to each other. Past healthcare reform proposals compared.

The Cost of TrumpCare

The Committee for a Responsible Federal Budget did a review of Trump’s healthcare plan. The following article shows a breakdown of costs: MEASURING TRUMP’S HEALTHCARE PLAN. The end result is a cost of nearly $500 billion over ten years under conventional scoring and about $270 billion with dynamic scoring.

Note that this analysis does not include Mr. Trump’s call to negotiate aggressively for Medicare drugs, a policy that is not listed on his website. He has previously claimed that $300 billion a year could be saved through negotiation, a claim we rated as false because Medicare will only spend an average of $111 billion each year on prescription drugs. Based on previous estimates by CBO, actual savings would likely be small or negligible.

NOTE: The plan assumes a true repeal of ObamaCare, which is valid given Trump’s statements, but isn’t necessarily what we would get from a Trump President.

NOTE: Like him or hate him, Trump has mentioned some really important health policies like expanding Medicaid and debating drug costs for Medicare. These didn’t exactly make it into the Trump plan in plain English, but all Trump-ism aside it is a mistake to not point out the benefits of things like debating drug prices for Medicare.

TrumpCare As Written on DonaldTrump.com

Below is an annotated version of TrumpCare. I simply explain what each measure means for America and ObamaCare.

1) 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.

COMMENT: To be clear no Republican will actually repeal ObamaCare. That is just layman for get rid of the mandates, subsidies, preexisting conditions, under 26, and specifically regulations on key businesses favored by the GOP. This doesn’t mean Trump plans to do all of this, he says the mandate (we have to assume that means subsidies and a few other regulations, but he doesn’t explicitly say it). (See why republicans can’t just repeal ObamaCare).

2) 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.

COMMENT: Republicans have always wanted to sell insurance across state lines. The conversation as to why or why not is nuanced. Not a bad idea, would make his constituents happy. (See The Problem With G.O.P. Plans to Sell Health Insurance Across State Lines).

3) 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.

COMMENT: Deducting health insurance premiums makes a lot of sense. People are getting taken to the cleaners with rate increases. Trump actually says he will expand Medicaid here too (or eluded to a variation of this)… that is potentially a big deal and very opposite of what the Cruz’s and Rubio’s of the world want. (See why Medicaid expansion is so important).

4) 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.

COMMENT: The Republican playbook part two. Expanding HSAs sounds great, but the actual policy is typically code for, “benefit upper-middle class who can afford to fund HSAs”. Essentially the GOP gives people a free 1,000 to fund an HSA, but as much as I love HSAs… you really can’t fund $3,000 to $6,000 for the tax benefits if you don’t have the extra income. (Learn more about HSAs).

5) 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.

COMMENT: If Trump didn’t just suggest expanding Medicaid-ish I would be shocked to realize that Trump just called for war on the price setters of the healthcare industry. I’m pretty sure he is implying he will let Medicare negotiate drug prices. (See why Drug costs are crippling the American taxpayer).

6) 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.

COMMENT: The Republican playbook part three. Not a bad move, but block-grants sound better on paper. (See why block grants are worse than they look on paper).

7) 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.

COMMENT: Trump just suggested what would account to big Phrama losing a ton of money (once you pay non-US prices you’ll never go back). (See why the US pays more than other countries for drugs).

TrumpCare as Spoken By Donald Trump

Trump is a wildcard, that much is clear.

Is Trump a Liberal from New York playing to the Republican base? Will he build a wall? Is he trolling Republicans? Is he trolling America? These questions are hard to say for sure. All we can do is listen to what he is saying and judge it for what it is.

Single Payer – Trump Style

Trump has essentially insinuated that he plans to implement a market-driven version of single payer. He made this very clear at one debate where his dialogue with Cruz focused on the Medicaid side:

CRUZ: So does the government pay for everyone’s health care?

TRUMP: … I’m not fine with it. We are going to take those people…

CRUZ: Yes or no. Just answer the question.

TRUMP: Excuse me. We are going to take those people and those people are going to be serviced by doctors and hospitals. We’re going to make great deals on it, but we’re not going to let them die in the streets.

CRUZ: Who pays for it?

COMMENT: Umm….. I can’t help but sort of like this guy. Notice the way he destroys the other Republican candidates with his well placed tactics. The guy operates like a machine, he is winning the GOP, and I like some of his healthcare policies. He is no Bernie, but he is… something.

Go to about 8 minutes into the video blow and see Trump somehow win a debate against Republicans by pushing moral healthcare policies. Strange…

Learn more about Donald Trump on HealthCare from ontheissues.org.

How is TrumpCare Different From ObamaCare?

TrumpCare is more like Republican healthcare reform meets BernieCare. It has little in common with ObamaCare outside of Medicaid expansion. Taking Trump for his word it is a complete repeal of the ACA, but in reality this makes no sense. Likely it just drops the mandates and subsidies, pushes Medicaid expansion, deregulates a little, regulates a little, and initiates some version of free-market single payer.

I’m not going to lie, Trump’s stance on immigration and the wall is too much to bare, but on healthcare alone… his plan is actually pretty darn good. Just got to take a closer look at the details to really know what a Trump President would do. Is, “we aren’t going to let them die on the streets” an empty promise or a real one? That is the question.

NOTE: I’ll add more to this page as we move toward. If Trump makes it to the primary then naturally his policies will become clearer and we will have more to dive into. Politicians almost always put out a rough outline, the PPACA is 1,000 pages of legislation, so we can’t make a completely fair comparison just yet. Stay tuned.