The president cited the plan's failures and outlined five principles that he said Congress should use in its legislation to replace the Obama administration’s healthcare reform law.
This article first appeared March 2, 2017 on MedPage Today.
President Trump, during a speech to lawmakers on Tuesday evening, presented a broad outline of how the Affordable Care Act should be replaced—incorporating many of the reform ideas traditionally offered by Republicans.
"Obamacare is collapsing—and we must act decisively to protect all Americans," he told a joint session of Congress. "Action is not a choice—it is a necessity."
The president began the Obamacare section of his speech by citing the plan's failures. "Mandating every American to buy government-approved health insurance was never the right solution for our country," he said. "Obamacare premiums nationwide have increased by double and triple digits ... One-third of counties have only one insurer and they're losing them fast—losing them so fast, and they're leaving, and many Americans have no choice at all."
"Remember when you were told that you could keep your doctor, and keep your plan? We now know that all of those promises have been broken," he said. "So I am calling on all Democrats and Republicans in Congress to work with us to save Americans from this imploding Obamacare disaster."
Trump outlined five principles that he said Congress should use in its legislation to replace the ACA:
- Ensure that Americans with pre-existing conditions have access to coverage, with a "stable transition" for those currently enrolled in the healthcare exchanges
- Help consumers purchase coverage using tax credits and "expanded" health savings accounts, "but it must be the plan they want, not the plan forced on them by our government"
- Give governors "the resources and flexibility they need with Medicaid to make sure no one is left out," said Trump
- Put in place legal reforms "that protect patients and doctors from unnecessary costs that drive up the price of insurance—and work to bring down the artificially high price[s] of drugs, and bring them down immediately"
- Allow consumers to purchase health insurance across state lines—which, the president said, "will create a truly competitive national marketplace that will bring costs way down and provide far better care. So important."
Still to come, though, is the legislation that fills in the details of how these goals would be accomplished.
Trump also mentioned a few other healthcare issues in his speech. During a section on making America a great country again, he said, "Heroic veterans will get the care they so desperately need." He also pledged to "stop the drugs from pouring into our country and poisoning our youth—and we will expand treatment for those who have become so badly addicted."
Trump also criticized the FDA for its "slow and burdensome approval process." One of his guests at the speech was Megan Crowley, a 20-year-old woman with Pompe disease whose life was saved by a drug developed by a company her father founded.
"If we slash the restraints, not just at the FDA but across our government, then we will be blessed with far more miracles just like Megan," he said.
Former Kentucky governor Steve Beshear, who gave the Democratic response, criticized Trump's suggestions for ACA replacement. "Does the ACA need repairs? Sure it does," he said. "But so far, every Republican idea to replace the ACA would reduce the number of Americans covered, despite your promise to the contrary."
"These ideas promise access to care, but deny the importance of making care affordable and effective," he continued. "They would charge families more for fewer benefits and put the insurance companies back in control. Behind this is the idea that folks at the lower end of the economic ladder don't deserve healthcare—that it's somehow their fault that their employer doesn't offer insurance, or they can't afford to buy expensive health plans."
"In 2010, this country made a commitment that every American deserved healthcare they could afford and rely on. We Democrats are going to do everything in our power to keep President Trump and the Republican Congress from reneging on that commitment, but we're going to need your help by speaking out," he added.