Repeal and replace, but replace with what?

Donald Trump’s Healthcare Plan Would Leave 18 Million Americans Uninsured

Like the majority of Republicans, GOP presidential nominee Donald Trump has been adamant in his dislike for the Affordable Care Act, otherwise known as Obamacare. Trump has repeatedly joined in the swelling conservative chorus of “Repeal and replace!” and while there has been a lot of attempted repealing on the part of Conservatives, there has not been a lot of evidence of what they would use to actually replace it, until now.

Trump has unveiled his healthcare plan, and it has been analyzed by the nonpartisan Center for Health and Economy, a research group that includes both liberal and conservative experts. Using the health care concepts Trump has unveiled on his website, the Center for Health and Economy attempted to put hard numbers to the concepts. And, Yahoo! News reports, the numbers attached to Trump’s healthcare plan leave a lot of lower-income Americans out, stripping them of their current healthcare benefits gained under the Affordable Care Act.

In fact, the analysis states that 18 million Americans would lose their coverage under Trump’s proposed healthcare plan.

Furthermore, the Associated Press reports, the loss of insurance would not only fall disproportionately on those who are covered through Medicaid, the losses would happen quickly.

Assuming that a President Trump and a Republican Congress would actually be able to completely repeal the Affordable Care Act, Trump would turn Medicaid into a block grant, which means that federal money would be limited, and states would have a greater say on how to spend their allotment.

For those Americans who purchase their insurance directly, there would be “winners and losers,” the AP reports.

The incredibly unpopular requirement that all Americans must carry health insurance or else face a penalty would be eliminated, but the overwhelmingly popular stipulation that all people have access to affordable coverage, no matter health history or presence of preexisting conditions, would also disappear.

In addition to the elimination of the Affordable Care Act’s preexisting condition clause, the law’s “minimum benefit requirements,” which guarantee that the health insurance policy must meet or exceed basic coverage limits and protections, as well as financial protections, and limitations on health insurance companies to charge higher premiums to older adults, would also all be eliminated. Those benefits have come with an admittedly higher price tag, mainly for young, healthy adults seeking to purchase health insurance. In response to the elimination of such standards and regulations, insurance companies are expected to respond by offering low-cost plans without much actual coverage to young, healthy adults, meaning average premiums will actually fall by an estimated 20 percent under Trump’s healthcare plan.

In other words, premiums for young people would be significantly reduced — but so would their actual coverage.

The online insurance market, HealthCare.gov, will also be eliminated under Trump’s healthcare plan — and with it, tax credits for premiums and subsidies for out-of-pocket costs. People will be allowed to deduct their premiums from taxes, but the analysis states that a tax deduction does not help nearly as many people as the upfront tax credit, particularly those people whose incomes are modest.

The analysis states that, over time, some of those 18 million Americans who will initially lose their health coverage under a President Trump will be able to purchase a different type of coverage. But the study states that by 2026, there will still be 13 million more uninsured than what is currently projected under Obamacare — and chances are, those will be older, sicker people who desperately need healthcare.

Another expert who reviewed the study, but was not involved in the research, said he thinks the coverage losses could be even deeper than 18 million.

“You are going to get a lot thinner coverage both in terms of higher deductibles and fewer benefits,” said John Holahan of the Urban Institute think tank. “The policy is bad for people with high risk, and good for people with low risk.”

The study also found “substantial uncertainty” about one of Trump’s main ideas, and a popular Republican talking point — that allowing insurers to sell policies across state lines will promote competition and drive costs down. That popular conservative idea could, in 10 years’ time, lead to as many as 7 million people getting individual policies in a generous estimate — or as few as 1 million, the study found.

“The biggest wild card is (Trump’s) approach to allowing people to buy across state lines,” said Douglas Holtz-Eakin, a Republican economist, as well as a board member of the center.

Some of that uncertainty “stems from the fact that health insurance remains a local and regional business. Costs can vary dramatically around the country. A Texas company selling policies in New York City would have to charge higher premiums. Also, out-of-state insurers might struggle to build the networks of doctors and hospitals needed to attract consumers,” the AP reports.

There was no immediate comment from the Trump campaign.

On the other side of the political aisle, Hillary Clinton recently formally endorsed part of Senator Bernie Sanders’ healthcare proposals. For more on that, click here.

[Photo by Isaac Brekken/Stringer/Getty Images]

Comments