Trump Victory Offers Chance to Repeal Obamacare

By Robert Lowes
WebMD Health News

Nov. 9, 2016 -- This year's bitterly fought presidential election had little to do with health care. But now that real estate magnate Donald Trump has won, it's likely to be a priority once he takes office.

The Republican nominee, a billionaire and reality-TV star, told raucous crowds that he would "make America great again." He will try to fulfil his promise to dismantle President Barack Obama's signature legislation: the Affordable Care Act, also known as Obamacare. Trump proposes to replace it with free-market solutions to the nation's health care problems, solutions that Republicans have championed for years.

A political novice, Trump won more than the 270 electoral votes needed to defeat former Secretary of State Hillary Clinton.

Trump may have a friendly Congress to work with in his first years in office. Republicans were expected to maintain control of both the Senate and House.

Most of Trump's health care pronouncements have focused on Obamacare, which he wants Congress to repeal. He has publicly advocated for health care that is more accessible, affordable, and higher quality. "We must ... make sure that no one slips through the cracks simply because they cannot afford insurance," states his campaign website.

One of his most touted prescriptions for health care is allowing insurers to sell their policies across state lines, designed to promote competition and reduce premiums. Two other fixes are allowing individuals to use pretax dollars to purchase coverage, and open health savings accounts, which Trump says will appeal to young healthy Americans who can afford high-deductible insurance plans.

Trump says he wants to improve Medicaid by contributing federal dollars to state programs in the form of block grants. He says that block grants will give states the right to say how to spend the money. At the same time, he says that the jobs created during his administration will lessen public dependence on Medicaid as well as the Children's Health Insurance Program.

In a nod toward free-market consumerism, Trump wants to require doctors and hospitals to be transparent about what they charge so that patients can shop for the best prices. Similarly, he proposes to give Americans the option to import less expensive drugs from other nations as long as they are safe and dependable.

The RAND Corporation determined that if his key health care proposals were enacted, an estimated 25 million people would lose coverage while the federal deficit would increase to $41 billion unless the lost revenue is replaced.

A recent Kaiser Family Foundation survey ranked health care low on the list of issues of importance to voters in 2016, and Obamacare even lower. When asked what should be a top health care priority for the next president and Congress, respondents said that first, government should help:

  • Ensure that high-cost drugs for chronic conditions such as hepatitis and cancer are affordable (74%)
  • Lower prescription drug costs in general (63%)
  • Make sure health plans have enough physicians and hospitals in their networks (57%).

Only 37% said repealing the Affordable Care Act should be the first order of business. And in another set of questions, more respondents said the law should be preserved as-is or even expanded (49%) rather than scaled back or junked (41%).

SOURCES: Trump campaign website RAND Corporation, "Estimating the Impacts of the Trump and Clinton Health Plans" Kaiser Family Foundation, "Kaiser Health Tracking Poll, October 2016," Oct. 27, 2016 Hillary Clinton speeches

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