Affordable Care Act under the Trump administration, 2017
From Ballotpedia
Trump Administration (first term)  Vice President Mike Pence Cabinet • White House staff • Transition team • Trump's second term |
Domestic affairs: Abortion • Crime and justice • Education • Energy and the environment • Federal courts • Firearms policy • First Amendment • Healthcare • Immigration • Infrastructure • LGBTQ issues • Marijuana • Puerto Rico • Social welfare programs • Veterans • Voting issues Economic affairs and regulations: Agriculture and food policy • Budget • Financial regulation • Jobs • Social Security • Taxes • Trade Foreign affairs and national security: Afghanistan • Arab states of the Persian Gulf • China • Cuba • Iran • Iran nuclear deal • Islamic State and terrorism • Israel and Palestine • Latin America • Military • NATO • North Korea • Puerto Rico • Russia • Syria • Syrian refugees • Technology, privacy, and cybersecurity |
| Polling indexes: Opinion polling during the Trump administration |
President Donald Trump's main healthcare policy initiative was working to fulfill his campaign promise to repeal and replace the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare. He expressed his support for the House and Senate bills that proposed modifying parts of the ACA. The House passed its bill—the American Health Care Act of 2017—but members of the Senate were unable to agree on a final replacement plan, leaving most of the provisions of the ACA in place. Congress removed the law's individual mandate, which took effect in January 2019.[1]
In October 2017, Trump issued an executive order directing members of his Cabinet to create rules that would allow small businesses to collectively buy health insurance through association health plans, expand short-term health coverage, and expand the use of Health Reimbursement Arrangements (HRAs). The order did not make direct changes to existing health insurance rules; instead, it directed agencies to consider new rules that would be subject to a notice and comment period.
The Trump administration also announced that it would end cost-sharing reimbursements. The administration announced that it would not make the payments scheduled for October 18, 2017, stating that the payments were not formally appropriated by Congress and were, therefore, illegal. Under the ACA, insurers who offered plans on the exchanges were required to provide the reductions, even without reimbursements from the federal government. Trump said that he was committed to passing a bill to repeal and replace the ACA. Before signing the executive order on October 12, 2017, Trump said, “Today is only the beginning. In the coming months, we plan to take new measures to provide our people with even more relief and more freedom. … And we're going to also pressure Congress very strongly to finish the repeal and the replace of Obamacare once and for all. We will have great healthcare in our country.”[2]
The comments of members of the Trump administration on repealing and replacing the ACA appear below.
Trump administration officials on repealing and replacing the ACA
President Donald Trump
- On July 31, 2017, Trump tweeted, "If ObamaCare is hurting people, & it is, why shouldn't it hurt the insurance companies & why should Congress not be paying what public pays?"[3]
- On July 29, 2017, Trump tweeted, "If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!"[4]
- On July 24, 2017, the day before the Senate was expected to hold a procedural vote to begin debating healthcare, Trump said in a speech, "Every Republican running for office promised immediate release from this disastrous law...so far Senate Republicans have not done their job in ending the Obamacare nightmare.”[5]
- On June 30, 2017, Trump said that the Senate should vote to repeal the ACA if they were unable to pass the Better Care Reconciliation Act of 2017 (BCRA). He tweeted, "If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!"[6]
- On June 24, 2017, Trump tweeted, "Democrats slam GOP healthcare proposal as Obamacare premiums & deductibles increase by over 100%. Remember keep your doctor, keep your plan?"[7]
- On March 24, 2017, after a failed attempt to pass the AHCA, Trump was asked if it was "fair to Americans to let Obamacare explode?" Trump replied, "Well, it's going to happen. There's not much you can do about it. It's going to -- bad things are going to happen to Obamacare. There's not much you can do to help it. I've been saying that for a year and a half. I said, look, eventually it's not sustainable. The insurance companies are leaving -- you know that. They're leaving one by one, as quick as you can leave. And you have states, in some cases, who will not be covered. So there's no way out of that. But the one thing that was happening, as we got closer and closer, everybody was talking about how wonderful it was, and now we'll go back to real life and people will see how bad it is. And it's getting much worse. You know, I said the other day, when President Obama left -- '17, he knew he wasn’t going to be here; '17 is going to be a very, very bad year for Obamacare. Very, very bad. You're going to have explosive premium increases. And the deductibles are so high people don’t even get to use it. So they'll go with that for a little while. And I honestly believe -- I know some of the Democrats, and they're good people -- I honestly believe the Democrats will come to us and say, look, let's get together and get a great healthcare bill or plan that's really great for the people of our country. And I think that's going to happen."[8]
- While speaking at the Conservative Political Action Conference on February 24, 2017, Trump said, "We also inherited a failed health care law that threatens our medical system with absolute and total catastrophe. Now, I’ve been watching -- and nobody says it -- but Obamacare doesn’t work, folks. I mean, I could say -- I could talk -- it doesn’t work. And now people are starting to develop a little warm heart, but the people that you’re watching, they’re not you. They’re largely -- many of them are the side that lost. You know, they lost the election. It’s like, how many elections do we have to have? They lost the election. But I always say, Obamacare doesn’t work. And these same people two years, and a year ago, were complaining about Obamacare. And the bottom line: We’re changing it. We’re going to make it much better. We’re going to make it less expensive. We’re going to make it much better. Obamacare covers very few people. And remember, deduct from the number all of the people that had great health care that they loved, that was taken away from them; was taken away from them. Millions of people were very happy with their health care. They had their doctor, they had their plan. Remember the lie -- 28 times. 'You can keep your doctor, you can keep your plan' -- over and over and over again you heard it. So we’re going to repeal and replace Obamacare. And I tell Paul Ryan and all of the folks that we’re working with very hard -- Dr. Tom Price, very talented guy -- but I tell them from a purely political standpoint, the single-best thing we can do is nothing. Let it implode completely -- it’s already imploding. You see the carriers are all leaving. I mean, it’s a disaster. But two years don’t do anything. The Democrats will come to us and beg for help. They’ll beg, and it’s their problem. But it’s not the right thing to do for the American people. It’s not the right thing to do."[9]
- On February 18, 2017, Trump said, "We are going to be submitting in a couple of weeks a great healthcare plan that's going to take the place of the disaster known as ObamaCare. It will be repealed and replaced. Just so you understand, our plan will be much better healthcare at a much lower cost. OK? Nothing to complain about."[10]
- On February 5, 2017, Trump was asked if his administration would roll out a healthcare plan to replace the ACA in 2017. Trump said, “Yes, in the process and maybe it’ll take till sometime into next year but we’re certainly going to be in the process. You have to remember Obamacare doesn’t work so we are putting in a wonderful plan. It statutorily takes a while to get. We’re going to be putting it in fairly soon, I think that yes I would like to say by the end of the year at least the rudiments but we should have something within the year and the following year.”[11]
- On January 11, 2017, Trump said, "We're going to be submitting, as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan. It will be repeal and replace. It will be essentially simultaneously. It will be various segments, you understand, but it will most likely be on the same day or the same week, but probably the same day, it could be the same hour.”[12]
- After Trump called for a simultaneous repeal and replace plan, Rep. Chris Collins (R-N.Y.) said, "I believe that President-elect Trump’s timeline is a tighter timeline than our leadership was speaking about a month ago. ... If he’s able to actually present a comprehensive plan that he says, 'I would sign this into law,' that would shorten the cycle a lot because we have six or eight plans."[12]
- On January 5, 2017, Trump wrote in a series of tweets: "The Democrats, lead by head clown Chuck Schumer, know how bad ObamaCare is and what a mess they are in. Instead of working to fix it, they do the typical political thing and BLAME. The fact is ObamaCare was a lie from the beginning. 'Keep you doctor, keep your plan!' It is time for Republicans & Democrats to get together and come up with a healthcare plan that really works - much less expensive & FAR BETTER!"[13]
- On January 4, 2017, Trump wrote in a series of tweets: "Republicans must be careful in that the Dems own the failed ObamaCare disaster, with its poor coverage and massive premium increases like the 116% hike in Arizona. Also, deductibles are so high that it is practically useless. Don't let the Schumer clowns out of this web...massive increases of ObamaCare will take place this year and Dems are to blame for the mess. It will fall of its own weight - be careful!"[14]
- In an interview on "60 Minutes" on November 13, 2016, Trump said that healthcare would be one of his top three priorities to initially address. Trump called the protection of individuals with pre-existing conditions one of the "strongest assets" of the Affordable Care Act and noted that he would keep that feature and the extended coverage of adult children under their parents' health insurance plans. Trump added that he aimed to repeal and replace the ACA "simultaneously."[15] A few days earlier, in an interview with The Wall Street Journal on November 11, 2016, Trump said that he would act "quickly" to change healthcare.[16]
During the 2016 presidential election, Trump advocated healthcare reform based on free market principles. He said that he would repeal Obamacare, reduce barriers to the interstate sale of health insurance, institute a full tax deduction for insurance premium payments for individuals, make Health Saving Accounts inheritable, require price transparency, block-grant Medicaid to the states, and allow for more overseas drug providers through lowered regulatory barriers. Click here to read more of Trump's public comments on healthcare before and during the 2016 presidential election.
Vice President Mike Pence
- On July 10, 2017, Pence said that the Senate should vote to repeal the ACA if they were unable to pass the Better Care Reconciliation Act of 2017 (BCRA). He said, “If they can’t pass this carefully crafted repeal and replace bill — do those two things simultaneously — we ought to just repeal only.”[17]
- On June 5, 2017, during a listening session on healthcare with women entrepreneurs, Pence said, "The truth is the American people are struggling under the weight of the failed policies of Obamacare, and it must go. Secretary Price and his team at Health and Human Services released a study just two weeks ago showing that in real numbers premiums have more than doubled under Obamacare since 2013, up 105 percent. Now, I was in the Congress when Obamacare was passed into law, and I remember all the promises -- if you like your doctor, you can keep them. Remember? If you like your insurance, you could keep it. But the central promise was the cost of health insurance would go down, and here we are that since 2013 alone premiums across this country have increased by 105 percent. America can't afford Obamacare any longer. President Trump and our administration are working every day with members of Congress, and we're not going to rest until we repeal and replace Obamacare with the kind of healthcare reform the American people deserve, healthcare reform built on consumer choice, on free-market principles, on state-based innovation, and a respect for the doctor-patient relationship."[18]
- On April 1, 2017, during a speech at Dynalab Inc, in Reynoldsburg, Ohio, Pence said, "The President and I know what all of you know -- that every day Obamacare survives is another day that the American people struggle. We all know the truth about this failed law. Higher prices, lost plans, fewer choices -- Obamacare is a burden on the people of Ohio and it’s a burden on Ohio’s job creators. That’s why the President has worked so hard to keep his promise to the American people to repeal and replace Obamacare with something that actually works. ... Obamacare is going to continue to explode, putting a great weight on millions of Americans. But the President and I have faith. We have faith that Congress is going to step and do the right thing. Even as we speak, I’m told the members of Congress are forging ahead -- working to craft legislation that will usher in the end of Obamacare. So be assured of this, folks here in the Buckeye State, when Congress finally decides to repeal and replace Obamacare, President Trump and I will be ready to work with them hand in glove. You can take it to the bank: President Trump is never going to stop fighting to keep the promises he made to the American people -- and we will make America great again. We will repeal and replace Obamacare and give the American people the world-class health-care they deserve."[19]
- On March 25, 2017, while speaking in Charleston, West Virginia, Pence said, "And I heard again from these West Virginia small business owners about the need to repeal and replace Obamacare. They told me how Obamacare stands in the way and stifles growth. It’s a burden not just to job creators, it’s also a burden to the American people. Folks, I wasn’t surprised to hear it because every promise of Obamacare has been broken. You all remember what they were. Seven years ago, after Obamacare was signed into law, they told us if you like your doctor, you can keep them -- not true. They said if you like your health plan, you can keep it -- not true. We were all told that the cost of health insurance would go down. Well, that one wasn’t true either. And West Virginia knows this better than most. It's heartbreaking to say that last year alone, Obamacare premiums here in West Virginia spiked by a stunning 32 percent. Over 40 percent of the state doesn’t have any choice of an insurance provider on the Obamacare exchange. West Virginians, and President Trump, we all know the truth about this failed law – that every day Obamacare survives is another day that America suffers. That’s why the President worked tirelessly over the last several weeks to get Congress to repeal and replace Obamacare. You saw his resolve to work with whoever he needed to work with, to call whoever he needed to call to get our plan across the finish line this week on Capitol Hill. I got to tell you, I was inspired by President Trump’s determination and commitment to keep his promise to the American people. And the President and I are grateful for Speaker Paul Ryan and all the House Republicans who stood with us in this effort to begin the end of Obamacare. But as we all learned yesterday, Congress just wasn’t ready. You saw it -- with 100 percent of House Democrats -- every single one -- and a handful of Republicans actually standing in the way of President Trump’s plans to repeal and replace Obamacare. We're back to the drawing board. You know, Nancy Pelosi, the leader of the Democrats in Congress, actually said yesterday was a victory for the American people. But West Virginia knows better. Yesterday wasn’t a victory for the American people. It was a victory for the status quo in Washington, D.C. And it was a victory for the disaster of Obamacare. But I promise you that victory won't last very long. The American people want Obamacare gone. And as the President said today, don't worry, America. He just tweeted this morning. Obamacare is going to continue to explode. And when Republicans and Democrats finally decide to come together and to repeal and replace Obamacare, we’ll be ready to get the job done."[20]
- On March 18, 2017, Pence discussed what he described as the failures of the ACA while speaking at Mac Papers in Jacksonville, Florida. Pence said, "Just last year, premiums, following Obamacare, spiked by 25 percent on average across America. Millions have lost their plans. In one-third of the nation’s counties, Americans only have one insurance company to choose from -- which essentially means they have no choice at all. Given all the failings, it’s no wonder that 400,000 fewer people enrolled in Obamacare this year. ... Florida is actually a textbook example of everything that's wrong with Obamacare. Here in the Sunshine State, Obamacare premiums rose by 19 percent last year -- with some increasing by nearly 40 percent. Over 400,000 Floridians were scheduled to lose their plans at the start of this year. And nearly three-quarters -- 75 percent -- of the state has no choice at all when it comes to health insurance. The truth is, Florida can’t afford Obamacare anymore. And job-creators in Florida can't afford it either. I heard it. I heard it earlier today. The small businesses represented here, they told me that Obamacare hits them with mandates, with regulations, with higher taxes and higher costs. Mac Paper is actually a great case in point. Since Obamacare went into effect, Mac was telling me that they've been forced to spend more than $300,000 not on jobs, not on investments that will create more jobs, but on just trying to comply with this failed law. That’s just not right. That money would have been better invested in your workers, Mac. And I know that's where you would have liked to invest it -- in payroll and in benefits, in your future, instead of being wasted on the failed policies of Obamacare."[21]
- On January 4, 2017, Pence met with House and Senate Republicans to discuss the plan to repeal and replace the ACA. He said, "The president-elect and I, working with the leaders of the House and Senate, are determined to keep our promise to the American people and that all begins with repealing and replacing the failed policy of ObamaCare." When asked about the process to replace the ACA, Pence said, “It will be an orderly transition to something better ... using executive authority to ensure it’s an orderly transition." Pence also said to reporters, “It will be an orderly transition to something better ... using executive authority to ensure it’s an orderly transition. We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for ObamaCare.”[22][23]
As a member of the U.S. House of Representatives, Pence voted against the Affordable Care Act in 2010. Two years later, Pence voted for the repeal of the ACA. He also recommended that the ACA be replaced "with a plan that includes consumer-driven health care." Click here to read more of Pence's public comments on healthcare before and during the 2016 presidential election.
Secretary of Health and Human Services Tom Price
- During an interview on March 12, 2017, NBC's Chuck Todd asked Price if the AHCA "which leaves much of the Obamacare architecture in place, is an acknowledgement that the health care system can’t be run by the free market alone." Price replied, "No, not at all. And obviously this is a transition that we're going through, but the important thing is to appreciate that the market as it is right now is failing. Obamacare, the ACA, has failed. You’ve got premiums going up, you've got deductibles where people have an insurance card but they don't have any coverage, got a third of the counties in this nation that only have one insurer offering coverage, five states with only one insurer offering coverage. That's not a choice nor is it responsible to the individuals who are going to be selecting the coverage. So what we need to do is to fix this, to move in a direction that puts patients and families and doctors in charge of their health care, and not Washington, D.C."[24]
- During his confirmation hearing, Sen. Lamar Alexander (R-Tenn.) asked Price how the plan to simultaneous repeal and replace the ACA might work. Price said, “Nobody's interested in pulling the rug out from under anybody. We believe that it is absolutely imperative that individuals who have health coverage should be able to keep health coverage and move, hopefully, to greater choices and opportunities … I think there's been a lot of talk about individuals losing health coverage That is not our goal or our desire, nor is it our plan.”[25]
- In 2015, Price said, “It [the ACA] needs to be fully repealed, because the first step out of the gate for Obamacare is a step in the wrong direction and that is for government control over every aspect of health care, so it's hard to fix the system that they have put in place without ending that premise that government ought to be running and controlling health care.”[26]
- In 2009, Price first introduced HR 2300—the Empowering Patients First Act—as the legislative replacement for the ACA. The bill proposed tax credits based on age, which individuals and families could use to purchase insurance policies, as well as a one-time tax credit for health savings accounts. The issue of tax credits has been a flashpoint among conservatives in debates over healthcare, with some favoring tax deductions over credits. Price said that he supports the idea of tax credits “because we felt it was cleaner.” Other features of Price’s bill included allowing insurers to sell policies across state lines and groups of businesses to purchase “association health plans.” Grants would be provided to states to help cover healthcare costs for individuals with pre-existing conditions. Under the Empowering Patients First Act, individuals on government programs like Medicare and Medicaid would be able to opt out and use their tax credit to purchase private coverage. Much of the bill was featured in House Speaker Paul Ryan’s “A Better Way” agenda.[27]
Footnotes
- ↑ Breitbart, "Donald Trump: ‘I’m 100 Percent Behind’ Obamacare Replacement Plan," accessed March 22, 2017
- ↑ WhiteHouse.gov, "Remarks by President Trump at Signing of Executive Order Promoting Healthcare Choice and Competition," October 12, 2017
- ↑ Twitter, "Donald J. Trump," July 31, 2017
- ↑ Twitter, "Donald J. Trump," July 29, 2017
- ↑ The Wall Street Journal, "Trump Urges GOP Senators to Overturn Affordable Care Act," July 24, 2017
- ↑ Twitter, "Donald J. Trump," June 30, 2017
- ↑ Twitter, "Donald J. Trump," June 24, 2017
- ↑ WhiteHouse.gov, "Remarks by President Trump on the Health Care Bill," March 24, 2017
- ↑ WhiteHouse.gov, "Remarks by President Trump at the Conservative Political Action Conference," accessed February 27, 2017
- ↑ The Hill, "Trump: ObamaCare replacement coming in 'a couple of weeks,'" accessed February 18, 2017
- ↑ The Hill, "Trump: ObamaCare plan could take until next year," accessed February 6, 2017
- ↑ 12.0 12.1 The Hill, "Trump says his team will put forward ObamaCare plan," accessed January 13, 2017
- ↑ Twitter, "Donald J. Trump," accessed January 5, 2017
- ↑ Twitter, "Donald J. Trump," accessed January 5, 2017
- ↑ CBS News, "President-elect Trump speaks to a divided country on 60 Minutes," November 13, 2016
- ↑ The Wall Street Journal, "Donald Trump, in Exclusive Interview, Tells WSJ He Is Willing to Keep Parts of Obama Health Law," November 11, 2016
- ↑ The Hill, "Pence endorses repeal and delay strategy on ObamaCare," July 10, 2017
- ↑ WhiteHouse.gov, "Remarks by the Vice President at a Listening Session on Healthcare with Women Entrepreneurs," June 5, 2017
- ↑ WhiteHouse.gov, "Remarks by the Vice President to Dynalab Inc, Reynoldsburg, OH," April 1, 2017
- ↑ WhiteHouse.gov, "Remarks by the Vice President in West Virginia," March 25, 2017
- ↑ WhiteHouse.gov, "Remarks by Vice President Mike Pence on Obamacare," March 18, 2017
- ↑ The Hill, "Battle lines drawn on ObamaCare repeal," accessed January 5, 2017
- ↑ The Hill, "Trump plans executive actions for ObamaCare repeal," accessed January 7, 2017
- ↑ NBC News, "Meet The Press 03-12-17," March 12, 2017
- ↑ Help.Senate.gov, "Statement of Congressman Tom Price, M.D. (GA-06)," accessed February 8, 2017
- ↑ The Washington Examiner, "Here's how Trump's HHS pick wants to replace Obamacare," accessed December 7, 2016
- ↑ Congress.gov, "H.R. 2300 - Empowering Patients First Act," accessed December 7, 2016
| |||||||||||||||||||
