He released this thing today. It's totally contradictory to what he said both on the trail and in interviews (that he supports a mandate and getting rid of pre-existing conditions) and in the debate (that he wants to get rid of pre-existing conditions without having a mandate). I guess someone told him you can't get rid of pre-existing conditions without a mandate and you can't win a Republican primary with a mandate and he made his decision.
Here are the main points:
https://www.donaldjtrump.com/positions/healthcare-reform
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.So since you eliminated the individual mandate, you can't get rid of pre-existing conditions, so we're back to where we were before Obamacare where because I had a precancerous mole removed once it costs me a billion dollars to get basic health insurance.
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.Everyone keeps suggesting this, there's no law
prohibiting sale of health insurance across state lines, only
inhibiting it, as Trump writes here, although when he talks about this he acts as though it's prohibited. The inhibitions are due to that GOP favorite, the tenth amendment. Different states have different regulations for how health insurance is to be administered and sold. This makes it hard to enter a new market, so instead of multi-state insurance companies we get state-by-state cottage industries where a company understands the laws and regulations for its state perfectly well and sells only within that state. Maybe it would be nice to get rid of this but what are you going to do, repeal the tenth amendment? Tell Florida it has to have the same skin cancer regulations as Minnesota? Come on now.
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.You can already deduct premium payments that exceed 7.5% of your gross income. I guess if he makes the case for reducing the threshold to 0% it's not a totally unreasonable position. The rest of this is fluff.
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.Republicans think individual HSAs will be the health care equivalent of a Roth IRA. All you're really doing is taking healthy money out of the insurance system. Healthy people contribute to their HSAs, while sick people use insurance. Who's paying for the insurance now? The return of pre-existing conditions scrambles all of this, of course.
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.Can't you already do this on healthcare.gov? thanks jfern.
If this is feasible, yes please.
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.This proposal, which the GOP has been trying to push through for almost 25 years, is basically the exact opposite of (2). You turn Medicare over to the states, cut spending considerably, and hope that the states can devise their own regulations and distribution services to make ends meet. There's never really been any evidence that it's possible. What the GOP is really hoping will happen is that they can make dramatic slashes, force the states to get creative and see if they can make it work, and then fill in the gaps with subsequent increases in the block grants on a state-by-state level. It's not entirely unreasonable, this is one of those back-and-forth policy debates where both sides actually have a good case and it's all a matter of speculation.
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.For drugs whose patent has expired, the main barrier currently is FDA checking that the drug is safe, which presumably Trump wants to keep, so I'll assume he's saying that he wants foreign drug providers to be able to compete in America during the patent period, so basically get rid of the patents. The old "this drug is $100 in America but ten cents in Mexico, wtf?" thing.
The reason this exists is so that if it costs $100 billion to cure cancer, a private company has incentive to do so because they can then sell the cure to the 1 million people who have cancer for $100,000 per cure and make their money back. If the drug costs 50c to manufacture, and some Mexican company can sell it for $1, then if the private American company has to sell it for the same price to stay competitive then they've paid 100 billion to make 1 million. That ain't right. It's funny to see Trump of all people advocating for this given how loudly protectionist he's been otherwise.
