Whether you are for or against them, it can’t be denied that Trump’s administration has had some fairly strong views on a lot of things over the past few years and if he gets re-elected, which is looking likely at the moment, we could be in for some more. And health is not receiving any different treatment (pun not intended)! There have been some significant shifts in healthcare policy in the last few years and in this article we are going to talk about some of the most significant changes or proposals.
Tax Cuts and Jobs Act
In December 2017 Trump signed the Tax Cuts and Jobs Act, which meant that in 2019, the Obamacare tax would be repealed for those individuals not opting to have health insurance. This has many different impacts on different groups of people. Firstly, a lot of people who were in good health decided to stop paying for health insurance as there was no longer a penalty for not doing so. This leaves people who aren’t healthy paying much higher premiums for their insurance. Since there are now fewer people funding the insurance companies, the people left on the schemes must pay higher prices to maintain the insurance companies’ profitability.
Furthermore, for people who are healthy and then get sick, or lack preventative treatments to stop things getting worse, they must then pay a lot more for emergency treatment which is much more expensive.
Work Requirements for Medicaid Patients
In January 2018 Trump’s administration decided to let states place work requirements on Medicaid patients. This meant benefits would be cut from any able-bodied recipients unless they were employed, a caregiver, or in school. This, however, does not affect about 95% of Medicaid recipients.
Insurance Across State Lines
In an effort to try and drive competition in insurance and stop the monopolies that the largest companies hold over the States (about 5 companies insure about half of the insured population), Trump decided to allow people to buy insurance from out of state. It is thought however that only the largest and most powerful companies will be able to operate on a national scale, making them even bigger and more powerful. They would likely raise prices and would also become exempt from the Affordable Care Act’s rules and state licenses. This would then mean that they wouldn’t have to offer the 10 essential benefits outlined by the ACA, and could potentially impose annual and lifetime limits!
Ease Restrictions on Short Term Health Plans
Under Obamacare, short term health plans could be for a maximum of 3 months, but in October 2018 Trump decided to let ACA subsidies pay for plans that could last up to 12 months. These plans are much cheaper than comprehensive plans but don’t offer the same benefits. This means that if you get sick and need emergency treatment it will cost a lot more, for everyone. It also means that because younger and healthier individuals are the ones that are more likely to opt for this sort of plan, the burden of higher premiums will be left on people who are already sick who are on the comprehensive plans.
Stopped Reimbursing Insurers
In 2017 Trump stopped paying reimbursements to insurers for co-pay, and low-income deductible waivers! Citing congress for not having found the funds to do so.
In March 2017 Trump decided he wanted Medicare to negotiate with drug companies for lower prices on prescription drugs, but this was not successful as medicare are not allowed to negotiate. It was also estimated that the negotiating would not save much since insurance providers already do quite a lot of negotiating.
In May 2018 Trump blamed rising drug prices on a multitude of things such as drug manufacturers, pharmacies and insurance companies. He requested that drug companies post their prices publicly to give consumers the chance to shop around and hopefully drive down prices.
The Trump administration’s plans and actions on medicare and health in America have been somewhat extreme, plans more so than actions as many were not acted upon, but if he wins another term in office they may be realized. It is yet to be seen the full extent, good or bad, of Trump’s changes to healthcare in America. But hopefully, this article has shed some light on some key decisions that have been made so far in his term in office.