Oct 22, 2017
Having failed three times to get Congress to “repeal and replace” the Affordable Care Act (ACA), Donald Trump issued executive orders to overhaul it. And then he declared: “This is something that millions and millions of Americans will be signing up for. They’ll be very happy, and they’ll get great care.”
Happy? Not hardly – not unless they wanted insurance that provides little coverage! Great care? Not a bit of it!
Trump’s order would allow insurance companies to offer “short-term” plans that don’t cover essential health exams, and that don’t limit the amount you have to pay in a year. Under the ACA, such plans could last only three months. Under Trump’s plan, they could last for a year – in other words indefinitely, since insurance coverage lasts for only one year.
Trump also said he was going to cut off some subsidies the federal government gives to insurance companies offering plans on the individual ACA marketplace. The reduction of those subsidies simply means insurance companies will raise premiums. In fact, most already have, anticipating Trump’s changes.
Trump referred to the ACA subsidies as gifts to the insurance companies. He’s right, of course. But we can be sure that no matter how many executive orders Trump issues, he will not do anything that cuts insurance company profits.
He could have issued an order cutting their subsidies, while blocking the companies from raising rates.
He didn’t do that. No, all he did was swagger up to the podium to utter another self-important boast. But what does it all mean?
In fact, it’s not at all clear what Trump’s executive orders might do. The regulations haven’t been written. No details, no precise rules. And no one knows who will write them. Who has any idea what will come of it?
Some Republicans and Democrats in the Senate have now offered a “bi-partisan” plan to fund the subsidies anyway. Trump first said it was OK, then he said it wasn’t, then he said maybe!
Trump and the Republicans and Democrats in Congress are “playing politics” with this issue, trying to attach blame for a bad medical system on each other.
And isn’t that disgusting! Politicians “play politics,” while too many people can’t get decent medical care and almost everyone has to pay too much for it. Don’t think Trump isn’t a politician. He’s just a more brazen liar.
The reality is that medical coverage in this country has long been aimed at providing profit to the insurance industry, the banks behind them and other medical care industries. The Affordable Care Act was written by them. Whatever rules come out of Trump’s executive orders or new Congressional acts will be written for those companies.
Today, even after the ACA was set up and started running, 28 million Americans remain uninsured and many others are forced to buy expensive insurance plans and/or pay a great deal out-of-pocket when they go to the doctor.
To actually deal with the problem of people not getting the medical care they need, Congress and Trump would first of all have to be ready to take on the insurance companies. They would have to slash profits going to the pharmaceutical and medical supply companies. They would have to make hospital systems non-profit and publicly owned and adequately funded.
If Congress did that, the U.S. might be able to get rid of its shameful record: it is the country that spends more per person on healthcare than any other country in the world, but has worse health outcomes than any other industrialized country.
But to wait on Republicans and Democrats to actually devise a system that puts the population’s need for medical care first would be like waiting for politicians to sprout wings and grow halos. Who would be so foolish?