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Trump Supports GOP Health Care Plan, But It Isn't Everything He Wants

President Trump has tweeted his support of the Republican proposal to replace the Affordable Care Act, but it doesn't include all of the policies he has recommended.
Mandel Ngan
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AFP/Getty Images
President Trump has tweeted his support of the Republican proposal to replace the Affordable Care Act, but it doesn't include all of the policies he has recommended.

President Trump is offering some Twitter support for the Obamacare replacement plan put forward by House Republicans.

In a tweet Tuesday morning, Trump described the GOP blueprint as "Our wonderful new Healthcare Bill." He suggested it would be a welcome change from the Affordable Care Act, which he called "a complete and total disaster."

"I'm proud to support the replacement plan released by the House of Representatives," the president said Tuesday afternoon during a White House meeting with GOP lawmakers.

Trump's support could be crucial since the House bill is already facing opposition from conservative Republicans who see it as too generous and more moderate GOP Senators who worry it's not generous enough.

The bill would preserve the Medicaid expansion in Obamacare through 2020 while continuing to offer tax subsidies for those who purchase health insurance on the individual market. The measure would repeal taxes on wealthy Americans that help pay for those subsidies, do away with a tax penalty for those who fail to obtain insurance, and adjust the rules governing insurance premiums so in general younger, healthy people pay less while older, sicker people pay more. Young adults would still be allowed to stay on their parents' insurance until they turn 26. And insurance companies would have to offer coverage to people with preexisting medical conditions, though companies could charge a 30 percent premium if customers fail to maintain continuous coverage.

In a letter to lawmakers, Health Secretary Tom Price calls the GOP bill "a necessary and important first step." But it would not achieve everything on the president's health care wish list. Some ideas — like allowing insurance companies to sell policies across state lines or letting the government use its purchasing power to negotiate better drug prices — are not included, although the president still hopes to pursue those through other means.

"Don't worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout," Trump tweeted Tuesday. "I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!"

Price noted in his letter that congressional rules don't allow these provisions to be included in a budget reconciliation bill. Republicans want to use reconciliation as a vehicle for their health care overhaul to prevent a filibuster by Senate Democrats.

Trump was a fierce critic of Obamacare on the campaign trail, telling supporters in Jacksonville, Fla., just before the election, for example, that it's a "total catastrophe."

Trump was less definitive about his prescription to replace the Affordable Care Act, though he promised it would be "something so much better and so much cheaper."

"Everybody's got to be covered. This is an un-Republican thing for me to say," Trump told 60 Minutes in September. "I am going to take care of everybody. I don't care if it costs me votes or not. Everybody is going to be taken care of, much better than they're taken care of now."

Trump reiterated that goal in an interview with the Washington Post days before taking office.

"We're going to have insurance for everybody," Trump told the newspaper. "There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."

While the Congressional Budget Office has not yet offered a forecast of how many people would gain or lose coverage under the House Republican plan, it's likely to fall short of Trump's goal of universal coverage. The Affordable Care Act helped extend health insurance to about 20 million people while pushing the nation's uninsured rate to an all-time low.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.