Healthcare Series

So, What is Healthcare? Part 5: Trump Healthcare

After the Affordable Care Act was put into action via the Obama administration, many people were unhappy with the changes that took place. As a result, the drive to change or repeal the new system in favor of other structures gained support. One of the platforms that fueled President Trump’s campaign was the promise to alter the existing healthcare system and undo the changes that were making some of his voters unhappy.

Make note that the plan for the Trump administration and various republican supporters to repeal and replace the Affordable Care Act was seen as a difficult strategy to achieve, even from members within his own camp. As a result, the goal of the administration to change the healthcare system became to simply repeal or alter the current system, as no replacement was widely supported. Additionally, the political requirements to pass such changes were not strongly advocated for amongst the majority, leading amendments and changes to the existing system as the most feasible option. The changes are outlined clearly by CNBC and will be detailed here today.

What changes were proposed to take place in the reported bill to be passed through our legislative branch? According to CNN Money “American Health Care Act goes a long way to fulfilling the Republicans’ seven-year pledge to repeal former President Obama’s landmark health reform law.” The original bill passed in the House of Representatives would have removed the subsidies paid out to enrollees based on their income, a new initiative of the ACA mentioned in last week’s edition of “So, What is Healthcare.” Rather than just ending governmental support of all kinds for enrollees, the plan was to change the support by offering tax credits based on age instead. Additionally, the plan is to remove mandatory enrollment and making health insurance optional. Mandatory coverage was one of the biggest changes instituted by the Affordable Care Act and it has been a hot topic of debate since it’s inception. This would also remove the requirement for businesses to require health coverage to their employees, outsourcing insurance programs or leaving enrollment up to other avenues once again. These changes alter the basis of availability of plans and the requirements for enrollment. Other changes alter the structure of health insurance policies and coverage plans.

The proposal originally set out to allow insurers to offer plans that don’t include all of the elements mandated by the Affordable Care Act. These plans would be limited in the scope of coverage, allowing people to opt out of mental health coverage or maternity care. The idea is that people will have more flexible options when choosing an insurance plan that fits their lifestyle and the potential costs could be kept to a minimum for people who do foresee the need to have comprehensive coverage of these areas of treatment. The flip side of this is that it would make comprehensive coverage harder to access, and there is a potential that coverage could be more limited or less protective for people with pre-existing conditions. This is especially true because the proposed system would allow insurance companies to change their premiums based on pre-existing conditions. Limiting care for people with pre-existing conditions is a direct contradiction to Trumps goals of ensuring access to this population.

The proposed changes would also affect Medicaid by providing set allowances of funding per state. The idea is that this gives states more rights and control of the programs in their state and ideally allows for more resources and flexibility. There would be a per-capita cap limiting the amount of money each state has for the Medicaid program and the amount of money allotted for each enrollee. The concern here is that the shift in funding moves primarily to the individual states that not have the ability to support these programs without adequate federal assistance. This would cause a shortage of funds, leading to changes in requirements for Medicaid enrollment, difficulties in payment or benefit distribution and access, and reduce the amount and quality of care for patients using Medicaid.

2 weeks ago, the Senate was planning on voting on the latest version of he Republican health care bill. The perception of the bill at that time was that it would not have enough support to pass through Senate due to the opposition by democratic representatives and division amongst representatives of the republican party. After a number of delayed votes, the Senate rejected the proposal.

Want to check back on the previous parts of the series? Great! Check them out here: Part 1, Part 2, Part 3, Part 4


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