President Donald Trump said this weekend that the administration intends to unveil its long-awaited healthcare plan in the next couple of months as he gears up for a reelection bid.
Trump told ABC News in an interview Sunday that the White House already has the shape of a plan together. He declined to offer additional specifics on what might be included in the forthcoming policy proposal.
“We’re going to produce phenomenal healthcare,” Trump said. “And we already have the concept of the plan.”
Trump made similar, sweeping promises on the 2016 campaign trail, including a vow that under his administration the Affordable Care Act (ACA) would be repealed. A 2017 effort to do so failed in the Senate, but the House did pass the American Health Care Act (AHCA), which may offer a look at what the White House may be considering.
While running for the presidency in 2016, Trump campaigned on an “insurance for everybody” approach, but quickly threw support behind the Paul Ryan-led AHCA.
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Sources close to the president told The New York Times that Trump feels he needs something for the 2020 election that would counter Democrats running on a “Medicare-for-All” single-payer platform.
However, they noted that if a proposal is released in the near term, it may not be a comprehensive health policy platform but instead incremental changes that build on work already done in Medicaid, in the individual markets and on drug prices.
Trump’s interview Sunday comes on the heels of a victory lap Friday as his administration finalized its plan to expand health reimbursement arrangements, the last dangling thread of a 2017 executive order that aimed to inject additional choice into the ACA’s individual markets.
Under that order, the White House also lengthened short-term limited duration health plans and expanded options for association health plans. Critics of the proposals warned that they could pull people out of the marketplaces, destabilizing them as they were beginning to rebound.
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The Trump administration has also considered other notable changes to the ACA exchanges, including an end to so-called “silver loading,” a practice adopted by insurers after Trump pulled the plug on cost-sharing reduction payments, and an end to automatic re-enrollment.
Questions raised within CMS, HHS
Some in the industry have warned that these steps could lead to more people becoming uninsured—and internal data from the Centers for Medicare & Medicaid Services (CMS) back that up, according to a memo released by House Democrats.
The memo (PDF) from CMS Administrator Seema Verma to Department of Health and Human Services Secretary Alex Azar notes that these policies could lead to an additional 1.1 million uninsured people and could create notable disruption in the markets. These policy proposals could also lead some insurers to leave the market, creating bare counties and potentially even states where there are no unsubsidized plans available, according to the memo.
In a letter (PDF) to Azar, Democrats said these policies are evidence of ACA “sabotage” by the administration.
“The fact that the Trump Administration would finalize policies despite these serious warnings from CMS is deeply troubling, and it appears to be part of the Administration’s continuing efforts to sabotage the individual market, undermine the ACA, hinder consumers’ access to comprehensive health care coverage and weaken protections for people with preexisting conditions," they wrote.