In his address to Congress Tuesday night, President Donald Trump called for an end to the Affordable Care Act while voicing support for a key tenet of GOP leaders’ replacement plan that has met resistance from some within the party.
“Obamacare is collapsing, and we must act decisively to protect all Americans,” Trump said. “Action is not a choice—it is a necessity.”
He outlined five principles that he said should guide Congress as it works to create a better healthcare system:
- Ensure that Americans with preexisting conditions have access to coverage, and that there is a stable transition for those currently enrolled in plans available on the ACA exchanges
- Help Americans purchase their own coverage, through the use of tax credits and expanded health savings accounts. In a dig at the ACA’s essential health benefits requirements, Trump added that “it must be the plan they want, not the plan forced on them by the government”
- Give governors the resources and flexibility they need with Medicaid “to make sure no one is left out.”
- Give consumers the freedom to purchase health insurance across state lines, “creating a truly competitive national marketplace that will bring cost way down and provide far better care”
Trump’s support of tax credits to help people afford coverage is in line with a recently leaked draft bill from the House, which would give consumers age-based tax credits to purchase individual market plans. That provision received pushback from two prominent conservative House members, who characterized the tax credits as a “new entitlement program.”
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In addition, Trump’s mention of state flexibility regarding Medicaid could be seen as a reassuring nod to governors who have chosen to expand Medicaid eligibility in their states. Indeed, state leaders who attended the National Governors Association’s winter meeting last weekend indicated that GOP governors had yet to reach consensus on an ideal ACA replacement.
Watch Trump's speech:
Beshear’s response cites Kentucky’s embrace of ACA
In the Democratic response to Trump’s speech Tuesday, former Kentucky Gov. Steve Beshear pushed back against the GOP’s plans to scrap the ACA, saying his state reaped the benefits of embracing the law despite its conservative leanings.
Under Beshear’s administration, Kentucky expanded Medicaid eligibility and set up its own state exchange, Kynect. Thanks to those efforts, Beshear said in his speech, half a million Kentucky residents gained coverage—people who are “not aliens from some distant planet,” but “our friends and neighbors.”
While he acknowledged the ACA does need “some repairs,” Beshear said Trump and his fellow Republicans “seem determined to rip affordable health insurance away from millions of Americans who most need it.”
In Beshear’s own state, his GOP successor Gov. Matt Bevin has moved to shut down Kynect and roll back Medicaid expansion. In that effort, he’s had help from Trump’s pick for to lead the Centers for Medicare & Medicaid Services, Seema Verma.
Here's Beshear's speech: