President Trump announced Thursday that he would seek to guarantee health care coverage for Americans with preexisting conditions, a protection that is already part of the Affordable Care Act his administration is seeking to repeal.
“The historic action I’m taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions,” Trump said at an event in Charlotte, N.C., where he signed an executive order that he claimed would improve health care in the U.S.
Under the ACA, which was passed under former President Barack Obama, Americans with preexisting health conditions cannot be denied health coverage by insurers. Trump’s new executive order, meanwhile, amounts to a pledge and comes after he has repeatedly attempted to gut current health care law.
On a call earlier in the day, White House officials said that Trump’s “protections” for preexisting conditions would not actually be law should the ACA be repealed, but were a "defined statement of U.S. policy.” The White House also announced that Trump would be giving Congress a Jan. 1 deadline to pass legislation on surprise medical billing and encouraging more health care choice.
Without protections for preexisting conditions provided by Obamacare, the Kaiser Family Foundation estimated in 2016 that up to 52 million people could be denied coverage. Millions more would lose insurance if the Medicaid expansion that was adopted by dozens of states and Washington, D.C., is killed. A full repeal with no immediate replacement plan could also hurt the fight against opioid addiction and HIV.
For years, Trump has promised he would unveil a health care plan that would cost less than the ACA, or Obamacare, while providing better coverage. A Fox News poll released earlier this summer found that a record high of 56 percent of U.S. voters had a favorable view of Obamacare, which was up 4 percent from the prior year.
In June, the Trump administration filed a brief to the Supreme Court urging it to overturn the ACA in a case backed by 20 Republican-led states. The brief included a section arguing that the ACA’s protections for those with preexisting conditions must be overturned as well, contradicting Trump’s repeated statements that he and Republicans supported maintaining them.
“If we win, we will have a better and less expensive plan that will always protect individuals with preexisting conditions,” Trump claimed Thursday, failing to mention that his administration has not produced a replacement plan for the millions who rely on the ACA for care, much less a bill to be debated in Congress.
Health care was a top issue for Democrats in 2018, when they retook the House in the midterm elections. According to a Washington Post report, GOP House Leader Kevin McCarthy blamed the party’s failures in the 2018 midterms on their attempts to roll back preexisting conditions. The issue is expected to be a key focus again in the wake of the death of Justice Ruth Bader Ginsburg. Democrats have already stated that if Trump is allowed to replace Ginsburg with a sixth Republican-appointed justice on the nine-person panel, then the ACA and the health care of millions are in danger. On Sunday, Biden said voters “know their health care hangs in the balance in the middle of the worst health crisis in living memory.”
More than 202,000 Americans have died from the coronavirus and millions have lost their health insurance due to unemployment.
Republicans made a sustained effort to replace the ACA with a new plan during the first two years of Trump’s term, when they had control of both chambers of Congress in addition to the White House. The Congressional Budget Office found in March 2017 that the American Health Care Act (AHCA), the Republicans’ replacement proposal, would knock 14 million people off insurance in one year and 24 million more by 2026, while the AARP estimated it would raise health care costs for older Americans by thousands of dollars.
The Republican House passed an amended version of the AHCA in May 2017, leading to a Rose Garden celebration with Trump and then-House Speaker Paul Ryan, but the bill died in the Senate. The legislation would have slashed Medicaid for low-income Americans, despite Trump’s repeated promises to the contrary. The July 2017 “skinny repeal” vote that barely failed in the Senate following no votes from Republican Sen. Susan Collins, Sen. Lisa Murkowski and Sen. John McCain was estimated by the CBO to increase the number of uninsured Americans by 16 million by 2026 and bring about a 20 percent rise in premiums. Actuaries calculated that thousands more Americans would have died sooner if the Obamacare replacements had passed.
Early in his presidency, Trump was surprised by the complexities of attempting to overhaul a massive industry Americans use to stay alive.
“Now, I have to tell you, it’s an unbelievably complex subject,” he said in February 2017. “Nobody knew health care could be so complicated.”
During Thursday’s event, Trump also alluded to a plan that would send money to older Americans to spend on prescription drugs.
“Under my plan, 33 million Medicare beneficiaries will soon receive a card in the mail containing $200 that they can use to help pay for prescription drugs,” Trump claimed. “Nobody has seen this before, these cards are incredible. The cards will be mailed out in the coming weeks.”
The details of the plan, such as how they would be paid for, are unclear. A similar deal was almost announced earlier this year, but negotiations between the White House and pharmaceutical companies collapsed over the president’s idea to send out what some in the industry called “Trump Cards.”
“We could not agree to the administration’s plan to issue one-time savings cards right before a presidential election,” Priscilla VanderVeer of PhRMA, the industry’s largest trade group, told the New York Times. “One-time savings cards will neither provide lasting help, nor advance the fundamental reforms necessary to help seniors better afford their medicines.”
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