Donald Trump Reveals Details of His Health Care Plan

NBC News ^ | 03/02/2016 | Ali Vitali

[SeekAndFind]

Donald Trump released his health care plan Wednesday evening, finally detailing the way in which he would fulfill his campaign trail promise to repeal and replace Obamacare.

In a seven-point plan posted to his website and publicized by a tweet, Trump says he will do away with the individual health insurance mandate, as well as allow competition over states lines for health care plans, and block grant Medicaid to the states, allowing them to follow through on his prescription to "eliminate fraud, waste and abuse to preserve our precious resources."

The decision to go against the idea of an individual mandate is new for Trump, who told CNN during a February town hall before the South Carolina primary that he "likes the mandate" and that makes him "a little bit different" than other conservatives.

But Wednesday's plan outlines as the first point on the list: "Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to."

He counters that, however, by saying individuals should be allowed to "fully deduct health insurance premium payments from their tax returns."

The third bullet point goes on to say that "we must make sure no one slips through the cracks simply because they cannot afford insurance" and that "we must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it."

Further, Trump ties illegal immigration to his healthcare plan, writing "providing healthcare to illegal immigrants costs us some $11 billion annually ... If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country,

[marktwain]

The problem wih “repeal only” is that it puts the goverment squarelly back into the middle of healthcare again, which is what caused the current propblem.

The system before Obamacare still has government tentacles into so many areas that it created the mess Obamacare was suposed to fix.

You are saying “go back to that mess”.

Trump is saying, get most of government out of the system, and let the States be laboratories for what works.

I do not think we can get much better, as a practical matter.

The enormouse advantage of this plan is that it goes away from one size fits all detailed management of health care by the federal government.

[DoodleDawg]

Finally he puts his rambling comments into words. A couple of observations:

1. So he completely eliminates Obamacare. Good start. But also I see that coverage for pre-existing conditions as well as coverage for adult children are not in his plan. These were two parts of Obamacare that were very popular and that's not going to make people happy. Also having a plan without a requirement to have healthcare insurance will tend to drive up prices. So it won't make it easier for people to afford.

2. Will this create competition and drive prices down. If an insurance company does not do business in my state then it has no established network and would pay a much higher price for medical services they bill for. If they have no network in my state then I would pay a higher deductible, a higher copay and have to pay a higher percentage of the bill. So with higher costs for me and the insurance company then where is the benefit to me in buy their policy and where is the benefit to them in selling to me?

Sections 3 and 6 are contradictory. In three Trump want to expand Medicaid to cover more low-income people, something Obamacare tried and which about half the states refused to participate in. How would Trump change that. In six Trump wants to block-grant Medicaid money so that states could, theoretically, reduce coverage and use the funds elsewhere if they want to. I don't see where this helps with coverage.

Section 4 is puzzling. Health Savings Accounts already exist, they are tax deductible, and they can be set up either through an employer or by individuals. People need the money to contribute but the plan is already in place.

Section 5 is also available. The government publishes prices that are charged by hospitals for dozens of procedures so people could price-shop if they wanted. But healthcare isn't buying a new car. People go to the nearest hospital in the event of an emergency or they go to the one their doctor practices at. And the prices published are not the same that their insurance company pays, so people can comparison shop and still not know where their medical care will be the most expensive.

Section 7 doesn't make much sense either. If a company has a patent on a drug then they are the sole source for that drug and there is no room for negotiation. Then price is the price. If the patent has expired then the drug prices are already priced competitively and there may be little to be gained through competition.

All in all I don't see where it will reduce healthcare costs for all Americans. It's an example that there really isn't much the government can do to provide healthcare for all so they should do nothing. It only makes it worse and more costly, especially for the government.

[eartick]

I will mark you down as one of those “let people die in the street” people.

That has got to be you Hillary. Come on don't you have to wipe the server or something.

That is more liberal than the race card.......

[TheStickman]

“But that will not work economically unless everyone in the United States is forced onto the insurance roles.”

That’s a canard the insurance companies have been using against us forever.

[eartick]

"On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare."

Keep reading......keeeeeep going.....all the way to the end where he is going to get Congress to put in place......yeah that is the part. Read the words that sound somewhat familiar to the _resident in the WH now.

[DoodleDawg]

f people are gonna get to right off their healthcare premiums, doesn’t that mean that the government, we the people ,are paying for everyone’s healthcare?

You get to write off your mortgage interest and property taxes. Does that mean I'm paying for your house?

[MD Expat in PA]

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.

I don’t see very much here that changes over what is currently in place and has been in place on HSA’s even before “Obamacare”.

https://www.irs.gov/publications/p969/ar02.html#en_US_2015_publink1000204020

http://www.hsacenter.com/faqs.html

As of right now anyone enrolled in a qualified High Deductible Health Plan (HDHP) is eligible to open a Health Savings Account (HSA). A HDHP can be offered through an employer and the HSA administered through the employer’s heath plan insurer or 3rd party administrator or it a can be a privately purchased HDHP insurance plan and the individual can open an individual HSA through most banks.

If through an employer sponsored plan, the employee contributions are deducted from payroll pre-tax (i.e. tax free – subtracted from Box 1 – federal taxable earnings) and employer contributions if any are also tax free, subject to the annual contribution limits. Individual contributions to an HSA paid for with post tax dollars whether to an employer sponsored HSA or a private HSA paired with a private HDHP are tax deductible, subject to the current annual limits ($3,350 for individual coverage and $6,650 for family coverage).

As long as enrolled in a qualified HDHP, tax free contributions up to the current annual limits can be made and the funds, whether contributed by the individual, employee or employer or a combination are 100% retained by the employee and is currently portable if the employee changes jobs or changes insurance plans. If no longer enrolled in an employer or individual HDHP, while one can no longer make tax free contributions they can still use, tax free the available funds for qualified medical expenses, including deductibles. At age 65, withdrawals from an HSA can be used for any purpose without penalties but such withdrawals are subject to ordinary income tax.

Unlike an employer sponsored FSA, HSA’s currently do accumulate and the funds roll over from year to year, and if one changes employers or changes plans, as long as they enroll in another qualified HDHP, the funds can be rolled over to a new HSA, or if not enrolled in a HDHP, they can still retain their existing HSA account, and currently once the funds reach a certain amount, the funds can be invested and earnings from those investments are also tax free if used for qualified medical expenses or tax deferred if withdrawn after the age of 65 for non-medical expenses. And as of right now, qualified medical expenses include unreimbursed medical expenses of the accountholder, his or her spouse, or dependents, even if they are not covered under the accountholder’s HDHP.

Currently when a person dies, the funds in their HSA are transferred to the beneficiary named for the account. If the beneficiary is a surviving spouse, the transfer is tax-free. If the beneficiary is not a spouse, the account stops being an HSA, and the fair market value of the HSA becomes taxable to the beneficiary in the year in which the HSA owner dies.

I would be a lot more impressed if Trump’s plan detailed things like opening up HSA’s to everyone whether enrolled in a HDHP or not, greatly increasing the annual contribution limits, open it up to persons currently enrolled in Medicare, allow people to use funds tax free from the HSA to pay for health insurance premiums other than COBRA or LTC premiums, allow HSA funds to pay for certain OTC medications without an Rx (like FSA’s once did), and allow non-spouse beneficiaries to inherit HSA funds tax free.

But I don’t see any of that outlined in Trump’s plan so from my reading, what he proposes for HSA’s doesn’t change anything that isn’t currently in place.

[eartick]

But I don’t get preferring Hillary over taking a chance that they could be wrong about Trump.

I do not thing it is about preferring Hillary my FRiend.

In my case I despise Hillary to the bone. She is a charlatan and con artist that would sell her grandkids if it would benefit her own personal career. I will not speak for other Freepers as to preferring or not preferring her but I feel the feeling across the board is the same. You get some Trump supporters exaggerating this but it is plainly exaggeration.

Now Trump, I just feel he is not the right man at this time in history to lead us out of this mire we are in. He has too much liberal leanings for me.

I understand that Obama has shifted the Overton window analogy immensely during his term and now Trump is acceptable as a "conservative". I am old school and my roots as a old school conservative (hard work, honesty, squeezing a dime out of a nickel) leaves me on the far right (radical edge) because of the Overton shift. I would never trust Trump with my money, family, life or honor. If I am wrong about Trump, help vote him into office and he turns more left and continues to dismantle this Nation and shifting the Overton more left, where am I at now? What recourse do I have since I am now far right sitting on the radical edge? My Country is lost to me.

[LibsRJerks]

People on welfare programs for their health care don’t have to pay co-pays. Nice, huh?

No, they do not. I process insurance every day, and no, they do not have any co-pays, while I’ve seen some Americans who pay up to $50 per office visit just to be seen. Breaks my heart when it’s a young family, both parents working, shuffling, doing their best to make it without any assistance for anything. They just do it the old fashioned way and WORK for their living.

BTW, Medicare pts also do not pay co-pays. While I understand they paid into the program, I’m not sure why they shouldn’t pay at least something. A $5 co pay might cover some administrative costs.

[LibsRJerks]

I’m subsidizing people who are getting it for nothing.”
You are also buying their food, rent, car, entertainment products, phones, drugs, utilities and a virtual rainbow of goodies that increase as they increase the size of their families.
Doesn’t that make all feel warm and fuzzy all over?

Don’t forget car seats. Free ones. Never forget a time when I was in nursing school and doing my public health clinical. Watched as at least a room of 50+ welfare preggos in some Health Dept sponsored “pregnancy class” carried out brand new car seats, a nice brand, still in the unopened boxes.

I remember as a young mom saving for weeks to afford a car seat for my firstborn.

[DoodleDawg]

The government has no business being in the health insurance business.

Is there anything the government has gotten involved with that they didn't make worse?

[AFreeBird]

Read it again (red the actual document on website). Notice he said: under the “current tax system”.

[AFreeBird]

No they don’t. But this does repeal it. This also just redefines the rules on how it is sold. It’s now national, open to all companies across state lines (which does fall under the commerce clause), and there is no individual mandate.

[AFreeBird]

Great endorsements. Missing the Hollywierd crowd though.

[PTBAA]

“TRUMP: I just want to say, I agree with that 100 percent, except pre-existing conditions,...I want to keep pre-existing conditions.”

But Mr. Trump, what if people want to be cured?

He’d be much more palatable if he could relay his thoughts using coherent sentences.

“TRUMP:...I think we need it [pre-existing condition coverage]. I think it’s a modern age. And I think we have to have it.”

So apparently those old dead white Founding Fathers had it wrong when they purposely limited the powers of the Federal Government to those expressly laid out in the Constitution. How is Trump different than Bernie Sanders or Hillary Clinton in his thinking that the Constitution can be ignored if it would bar him from doing things he thinks should be done? Why would Trump stop treading on the Constitution for any other thing he wants once he is in office?

The specific issue of universal healthcare aside, his Progressive mindset should be an absolute disqualifier for a Conservative.

[trebb]

He lives in reality - many conjure up visions of a government that will allow folks to die in the streets - they are the ones who open the door for ObamaCare and Trump wants competition among doctors/insurance companies, remove the State barriers that currently exist and take care of those who can’t afford it but only for necessary treatments instead of leaving the whole menu open. It’s a huge step in the right direction even though there are many who would rather leaving a smoking crater in what we currently have w/o any thought as to how to keep the pieces together until such time as the new system shows things that need to be changed. It ain’t a LEGO set where you can tear it all apart and stash it in a box for a while then slap it back together again.

[Aleya2Fairlie]

Those people are going to pay proportionately. Who knows? We all might just get to go back to not paying for Flukey stuff too. Fluky might have to pay for her own birth control and those who choose health destroying lifestyles might have to go back to paying the piper, instead of everyone sharing in the cost.

[DoodleDawg]

Trump wants competition among doctors/insurance companies, remove the State barriers that currently exist and take care of those who can’t afford it but only for necessary treatments instead of leaving the whole menu open.

I don't think he's going to get any of that. Few industries are as set up to discourage competition and the health care industry is and Trump's proposals won't change it. Nor will it necessarily take care of those who can't afford it. It sounds good but it really isn't going to fix much of anything.

[DoodleDawg]

I think they’ll be kept.

Then why didn't he include them in his plan?

What good is health insurance when you can’t afford it?

True. But I don't see this plan making much of a difference in costs.

[DoodleDawg]

People who can’t afford it can enroll in expanded Medicaid/Medicare.

Medicare is for people 65 and older. If you qualify age-wise then you're in regardless of income. Medicare was supposed to be expanded under Obamacare and about half the states refused to do so. What makes you think they'll change their minds this time around?