Isn’t this how we got ObamaCare in the first place? Donald Trump told the Washington Post on Sunday that his plan to replace ObamaCare would soon get unveiled along with the plan coming from Congress, and that it would ensure access to health “insurance for everybody,” and that he rejected the idea that “if you can’t pay for it, you can’t get it.” Trump says he’s just waiting for Tom Price’s confirmation at HHS to release the plan:
President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid. …
As he has developed a replacement package, Trump said he has paid attention to critics who say that repealing Obamacare would put coverage at risk for more than 20 million Americans covered under the law’s insurance exchanges and Medicaid expansion.
“We’re going to have insurance for everybody,” Trump 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.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”
How serious is this? Trump is likely to dive into the nitty-gritty of trade deals, a topic that has always interested him and which relies on his own best talents. Up to now, Trump has not offered many specifics about health insurance reform except for some of the slogans in the Washington Post interview. Invoking Price’s confirmation as a condition for the release of the plan is doubly curious, because Price actually does have a plan for replacing ObamaCare, and it’s not based on the government guaranteeing insurance coverage for all. Price’s market-based reforms rely on bolstering competition and innovation in coverage, along with the freedom to choose whether one needs coverage or not.
Some of the rumbling on social media after the publication of this interview fretted over Trump’s predilection toward single-payer, a topic that also came up in the primaries. Trump scoffed at that characterization in the interview, noting his repeated rejection of single-payer systems over the past 18 months. The impression left by the somewhat ambiguous remarks from Trump isn’t that he’ll push single-payer, but more of another ObamaCare-style system run from Washington DC.
Trump also reiterated his desire to have Medicare and Medicaid directly negotiate on drug prices, an idea that will run into stiff opposition in Congress. A year ago, Trump claimed he could save America $300 billion a year with that policy, a number that is more than double what CMS spends on prescriptions overall. Not only would the actual savings be much more modest (if any result at all), it would distort the pharmaceutical market and dent the incentives for innovation and production — especially here in the US.
From his remarks, it appears that Trump is moving in the opposite direction of Congress. Republicans on Capitol Hill want to unwind federal control of insurance markets, while Trump’s remarks suggest that he’s looking for different ways of using and even extending federal control. If he’s serious about it, this could be the first conservative-populist fracture of the new session, and it might doom the entire agenda.