Pros & Cons of Trump's Proposed Health Care Plan

This year has proven to be a bit chaotic in terms of Americans going about their daily lives.  Today’s post will examine the pros & cons of President Trump’s Healthcare plan.  Tomorrow, I will examine the pros & cons of Joe Biden’s plan. 

I tried to put together a simple “pros and cons” list taken from information obtained from both partisan & non-partisan sources.  The information I will be referencing was gathered from both candidate’s own public websites, as well as, organizations such as the non-partisan Mayo Clinic and WebMD.  Over the last 4 years, all of us have been programmed to believe that the media is just distributing “fake news” and the trust in organizations like CNN, Fox News and the like has been nearly non-existent. Therefore, while I have read many of the reports that have been put out by these media outlets, I have chosen not include their findings or reports here.  It will be up to my readers to decide if I have been unbiased enough so that you can make an informed and truthful decision.

Let’s start with Trumps stance on healthcare:

Pros:

• In August 2020, President Trump expanded coverage Telehealth benefits under the Medicare & Medicaid programs as part of his response to the COVID-19 Pandemic.
• He also authorized funding for 185 Telehealth providers in 38 states.
•  Trump has promised during his 2016 & 2020 presidential campaigns to “repeal & replace” the original Affordable Care Act (Obamacare) in order to remove some of the more controversial parts of the bill.
•  Although he has not repealed the ACA, he has enacted several directives & orders to remove key portions of the bill such as the mandate that allows for fines to be levied against individuals & corporations who do not purchase healthcare.  NOTE: I placed this under the “pros” section because this has been a major point of contention for the majority of Republicans.  This is a pro for those who lean more to the right on health care policies while it would be “con” to anyone that leans to the left. 
• Believes that with a Free Market System, more options will be made available, which in turn will drive down prices and foster innovation.
• Believes that insurance companies should not be able to deny coverage to individuals with preexisting conditions.
• Advocates for transparency in health care costs to avoid “surprise” medical billing.
• Under President Trump’s proposed plan (known as Trump Care), it would provide an immediate reduction to the Nation’s deficit by saving approximately $15 billion per year until 2026.
• His plan eliminates the highly controversial mandate that was included in Obamacare. 
• It would increase the amount of contributions to HSA funds from $6,750 per family to $13,100. In addition, HSAs are not taxed as long as the funds are used for qualified medical expenses and if a balance is not used within the benefit year, it can be rolled over for use in the next year.  It would include over-the-counter medications as part of the qualified expenses & reduce the early withdrawal tax penalty from 20% to 10%.
•  It removes consumer taxes on medical equipment & devices, some prescription medications and some health insurance plans that would be taxed under Obamacare.
• Provides reciprocity to insurance companies to sell coverage across state lines without the need to for the companies to hold individual licenses for each state.  This increases competition with hope that it would drive down premium costs for consumers.  Companies would only have to hold a license in the state they are headquartered to be able to sell in the other 49 states.
• While it removes that mandate of coverage for preexisting conditions, it provides subsidies to individuals with preexisting conditions in order to cover the cost of higher premiums for coverage.  NOTE:  This is also a con in that it allows insurance companies to charge higher premiums on the basis of what they consider to be a preexisting condition – this includes simply being a female of child bearing age.
• Trump’s plan includes many of the more popular aspects of Obamacare such as the option to keep children on their parent’s policies until age 26.
• The cost of healthcare services would be tax deductible; combining this with the subsidies is thought to provide more relief low-income consumers.
• The tax penalties to large employers was removed AND the tax credits to small businesses were also rolled back.  By doing this, corporations would save a lot of money which could be used to inject more money into corporate economy.  NOTE: There is also a down side – Small Businesses would lose a badly needed tax credit that could eventually result in the failure of small businesses due to the rising costs of healthcare that they would be required to absorb without any benefit to the business itself. 

Cons:

• Trump’s proposal leaves approximately 24 million Americans without health insurance. This estimate is based on the removal of the individual mandate.  With its removal, stricter regulations would be enforced on how Medicaid & Medicare operate AND who would qualify for these programs.  As a result, Americans who cannot afford to purchase coverage within the marketplace but do not meet the qualifications for Medicaid and/or Medicare would go without coverage. 
• Less regulations, leaving insurance companies, medical care providers & pharmaceutical companies open to drive up costs & provide less.
• Waives the essential care benefits that are required under the ACA-including OB/GYN services, mental health services, etc.  The idea is to allow those who don’t require such services to have a waiver of coverage.  For example, a male consumer can waive coverage for OB/GYN services since he has no need for their services.  A person could waive coverage for mental health services because they don’t think they would use them.  The problem arises that one cannot foresee the future – just because those services may not be needed right now, doesn’t mean that the services would not be needed in the future.  Also, each state would be allowed to draft their own set of regulations, creating a whole new system of care.
• Trump’s plan increases costs to individuals with preexisting conditions, including females who have not yet reach menopause and are still able to reproduce.  Yes, it’s true – simply being female & of the age to carry babies in your belly is a preexisting condition!  Insurance companies would be permitted to deny policies, deny individual coverage for treatments and services or charge so much that the consumer could not afford the coverage on the basis of the consumer being female age 12-50 or 60 years old, having a preexisting condition such as diabetes, BMI of over 25, High Blood Pressure, history of depression, anxiety, PTSD, alcoholism, addiction, Heart Attack, Stroke, etc.  And that is even if you’ve had a clean bill of health after addressing these conditions in the past.  For example, let’s say you had been being treated for high blood pressure due to being obese.  You had weight loss surgery, lost enough weight to be considered “normal BMI”.  You no longer have to take high blood pressure medication or monitor your heart so closely.  You’ve had a clean bill of health for a couple of years by making lifestyle changes – but now you have to get a new policy.  The health insurance company would be allowed to review your medical history dating back to birth and deny coverage or charge a higher premium because of your past health conditions that no longer are a risk factor. 
• The removal of premium cost caps.
• Cost of care for Seniors would increase significantly.  Insurance companies would be allowed to increase the premium for Seniors up to 5 times more than what they would charge a younger a adult.  For example, a policy covering a 21 year old might cost $100; the exact same policy would cost a Senior Citizen $500. 
• Obamacare authorized an expansion of Medicaid to help those individuals who are unable to obtain coverage through the private sector.  Under Trump’s plan, this expansion would be rolled back, leaving poor individuals who are not able to obtain coverage on their own without any coverage at all. 
•  HSAs are STILL your money being used to pay for health care; which increases the total amount being spent on health care services & products.
• Trump allows up to a 30% surcharge if your health insurance coverage lapses for a specific period of time.  In addition, there would be surcharges for preexisting conditions.  While some subsidies would be available, they would be limited and would not cover the surcharges fully.
• Targets Planned Parenthood and abortion services.  Under Trump Care, funding for Planned Parenthood and any other organization or provider that received funding through the Federal Government could not make abortion referrals. This plan also cut or restricts coverage to private companies that would cover abortion services or referrals.  The only exception if federal funding was part of your healthcare plan was if abortion was needed in order to save the mother’s life or the pregnancy was a result of incest or rape.  You could not have a qualified plan that covered abortion services.
• No reduction of co-pays or deductibles. This could dramatically increase a person’s monthly medical expenses due no only having to pay the monthly premium, but also being required to pay co-pays AND deductibles.  Currently, that require this are still in place. (In addition to the monthly premium paid for coverage, some health plans require individuals to meet a deductible before the insurance coverage pays anything.  While the individual is trying to meet that deductible, they are also required to pay co-pays for certain services – for example, my coverage charges a $75 co-pay for Specialists, $300 co-pay for ER visits and $35 co-pay for our primary doctor.  In addition to these charges, we are required to meet a $5500 deductible before the insurance company will pay anything, which is only 75%.  We are required to pay 25% of the total in addition to the visit co-pays until another dollar amount is met – called Co-Insurance.  Once the co-insurance amount is met, then, and only then does the insurance company pay 100% of the charges beyond the visit co-pay amount.  So, lets say I go to the ER.  I have to $300 co-pay, 100% of the total charges up to $5500.  After $5500 is paid, then I would only pay 25% plus $300)  Sounds confusing doesn’t it?  Not only does it confusing but it can cause a family to go into bankruptcy.  Especially if they already live paycheck to paycheck without any form of assistance.

Trump Care could have had some success if it weren’t for the flaws. It shifts the brunt of costs onto the lower end of the income scale instead of subsidizing it from the upper end of the income scale. The rich get richer while the poor get poorer…literally.

Although the goal is to increase consumer choice in the marketplace; it is likely that the opposite would occur. People who do not wish to purchase coverage or who were healthy enough not to need it; could drop out of the market without penalty.  This could lead to insurance company “death spirals” that would decrease consumer choice.

Also, the added expenses to seniors could be an untenable position. Trump, himself, acknowledges that over 20 million people could lose coverage. The moderate gains on the national deficit pales in comparison to the potential harm that could happen over time under Trumps plan.