Examining the Implications of Trump’s Obamacare Repeal

President Trump delivered his first address to Congress on Tuesday and promoted his high-level policy wishes for the repeal of “Obamacare.” Trump called for access to coverage for those with pre-existing conditions, the use of tax credits, expansion of Health Savings Accounts (HSAs), “resources and flexibility” for Medicaid, drug price reform, and insurance sales across state lines. These proposals closely mirror those endorsed by Speaker Paul Ryan.

The comments come at the heels of criticism for the most recent draft repeal proposals for the Affordable Care Act (ACA). ACA repeal talks eventfully closed out the work week last Friday, with a leak of a proposed draft of the House’s ACA repeal proposal by Politico.

The draft was quickly marked as outdated by both members of the House as well as governors who convened in Washington this week. Despite this, the contents of the draft were also quickly criticized by both sides of the political spectrum and failed to get the support from much-needed groups within the House such as the Freedom Caucus and the Republican Study Committee.

The proposals include:

  • New age-rated tax credits
  • A 30% premium penalty on non-continuous coverage
  • Move to a 5-to-1 age-band rating
  • Protection of grandfathered and grandmothered plans
  • Grants states authority to determine Essential Health Benefits (EHBs)
  • Move to per capita spending for Medicaid
  • Repeal of mandate penalties and ACA taxes

Even though we can no longer expect the reconciliation proposal to look exactly like this proposal, this draft, previous policy agendas such as Ryan’s “Better Way,” and new Department of Health and Human Services (HHS) secretary Tom Price’s prior proposals present some common trends on what Republicans aim to present. Most notably, most proposals include versions of HSAs, interstate insurance, the use of high-risk pools, and the reform of Medicaid.

In a new memo, our Policy Team examines the most widely-cited Republican healthcare proposals, their components, and their limitations.



Gorman Health Group’s Summary and Analysis of the 2018 Medicare Advantage and Part D Advance Notice and Draft Call Letter is now available. Download now >>

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