TrumpCare: Five Ways Healthcare Could Change in America

Now that Donald Trump is the 45th president-elect of the U.S. and Republicans have secured a majority in both houses of Congress, we have a better idea of what changes in healthcare may occur over the next few years. Here’s a list of the most likely impacts.

  1. Repeal the Affordable Care Act (ACA)
    Trump has expressed repeatedly that he would like to repeal the ACA. However, some 20 million people might lose their insurance if this were to suddenly happen. It is almost certain that Congress will take legislative action to repeal or change key aspects of the law. According to the Republican plan, the pre-existing condition clause would remain, which means that individuals would not be denied coverage based on pre-existing medical conditions or demographics. However, the individual and employer mandate would be removed, so that people would no longer be forced to purchase health insurance. Also, the growth rate of Medicare spending would be reduced and new taxes and fees would be introduced.
  2. Make Premiums Tax-Deductible
    Before ACA, there were significant tax advantages for individuals with employer-covered plans, but not for those with individual policies. To solve this discrepancy, ACA used advance premium tax credits (APTCs) to allow the government to bridge the gap between the premium cost and payment limit. Trump’s plan would allow individuals to fully deduct their premiums, facilitating a free market for companies and individuals to obtain coverage.
  3. Use Health Savings Accounts
    Trump proposes to promote consumer-directed health measures by expanding tax incentives for health savings accounts (HSAs), which are medical savings accounts from which you can contribute or draw money tax-free. HSAs would no longer be available only to those enrolled in high-deductible health plans. Contributions would be tax-free and allowed to accumulate over time. Finally, HSAs could become part of an individual’s estate that could be bequeathed to heirs without penalty.
  4. Allow Health Insurance Companies to Sell Across States
    Trump believes that allowing insurance companies to sell policies across state lines would lead to lower insurance costs. Any provider that complies with state guidelines would be allowed to offer plans in that state.
  5. Change Medicaid Funding
    Under the ACA, Medicaid receives joint funding from the federal and state government. Trump would use block grants to fund Medicaid across the country. Under this program, the federal government would provide a fixed amount to states and state governments would be responsible for funding the rest without administration overhead.

Trump is also calling for greater price transparency among healthcare providers so that patients are aware of the best prices for various medical procedures and tests. He also believes that the cost of care could be reduced by removing barriers into the free market for drug companies. He envisions a market-based universal coverage that reduces the role of the federal government in the healthcare industry. Reforming healthcare remains a complex task. Exactly how and when these transformations will take place remains unclear.