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Trumpcare

Credit: Gage Skidmore - https://en.wikipedia.org/wiki/Political_positions_of_Donald_Trump#/media/File:Donald_Trump_by_Gage_Skidmore_5.jpg This article covers the seven-point platform proposed by President-Elect Donald Trump. Trumpcare is a strict rejection of Obamacare, the primary tenet of which is the repeal of the Affordable Care Act in its entirety.

Donald Trump's healthcare platform was released in March of 2016 and, like many of his policies put forward during the campaign, it is a seven-point plan.

As to be expected from a Republican candidate, Trump's policy is centered around the repeal of the Affordable Care Act[1].

1. Completely repeal Obamacare.

"Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to."

Several of Trump's policies uphold some aspects of Obamacare, namely the creation of tax-free Health Savings Accounts and inclusion of pre-existing conditions. Despite this, his platform overall is to repeal Obamacare and replace it with a free market. The primary tenet of his seven-point plan is that free market creates competition which leads to lower costs. The Congressional Budget Office has estimated that repealing Obamacare would in fact only save money in the first three years [2].  After that it estimates that the ten-year deficit will increase by over $350 billion.

2. Modify existing law that inhibits the sale of health insurance across state lines.

As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.

Trump insists that this is necessary in order to facilitate greater competition. "Look, the insurance companies take care of the politicians. The insurance companies get what they want. We should have gotten rid of the lines around each state so we can have real competition."[3]

3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system.

Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

Interestingly, this point in Trump's plan affects a very small number of people. This does not apply (because they already have the deductions) to Americans with no income tax liability (Americans receiving Medicare and paying their gap premiums), or to Americans who get insurance from work. It does not apply to those on Medicaid, the Veterans Administration, Tricare or CHIP either, because they already receive health insurance for free.[4]

4. Allow individuals to use Health Savings Accounts (HSAs).

Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

Credit: Evan Guest - https://commons.wikimedia.org/wiki/File:Trump_with_supporters_in_Iowa,_January_2016_(2).jpg

This point is particularly strange, considering that it's already a part of Obamacare and has, in fact, been available since 2003[5].

5. Require price transparency from all healthcare providers

This pertains especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

The free market is the cornerstone of Trump's policy, and transparency is fundamental to competition in the marketplace. With consumers unable to shop around or do price-comparisons, the industry has little to no incentive to raise prices, and just as little incentive to provide reasonable prices.

6. Block-grant Medicaid to the states.

Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.

Block-granting would have the federal government provide a specific budget amount to the states as a lump sum to use for the state-run Medicaid programs without the federal oversight and regulation. Critics of block-granting Medicaid claim that the funding would be outpaced by the growth of Medicaid costs.

7. Remove barriers to entry into free markets for drug providers.

For those companies that offer safe, reliable and cheaper products, Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers

Trumps fundamental response to Obamacare is to promote free markets. Allowing American consumers to purchase drugs from other countries is a further expansion of the idea that competition lowers prices.

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