“TRUMPCARE” OR SOMETHING ELSE?
(Mar. 31, 2017) — The Affordable Care Act, or ACA, while full of good intentions, was a contradictory piece of legislation in many ways. Its many mandates on the health insurance plan priced many out of private health insurance, swelling the rolls of Medicaid and Medicare. The health insurance mandate did nothing to improve the actual quality of care since the deductibles and high premiums meant that many people had to defer care or pay out of pocket for nearly everything before their new, more expensive health insurance policy kicked in. So, what will the Trump replacement for Obamacare look like?
Subsidies Out, Tax Credits In
Every version of the Trumpcare bill would eliminate the problematic subsidies for health insurance bought through state health insurance. Instead, tax credits would be available for everyone who buys health insurance. This eliminates the challenges many faced of losing health insurance subsidies because they earned $200 too much in a year and were hit with a bill for thousands of dollars.
Altering the Role of the States
The Trump alternative to Obamacare would aim to remove much of the authority the head of HHS received in Obamacare to determine what health insurance plans would and wouldn’t be required to cover. Instead, health insurance rulemaking would be returned to the states where it traditionally resided. This is why state level exchanges were part of the ACA – because of how different health insurance regulation was between the states.
Trumpcare would also give the states direct grants to administer as they see fit. They may choose to give State income tax credits families on a low income. The money could be used to fund new high-risk state insurance pools for those with pre-existing conditions, who cannot otherwise get health insurance, which was something shut down by Obamacare.
Trends in Healthcare that Legislation Won’t Change
There are a number of trends in healthcare that legislation will not change. Female doctors are less likely to work overtime as male doctors, resulting in a shortage of “labor hours” compared to the traditionally projected workloads set when medicine was predominantly populated by men. Legislation to raise the cap on the number of medical school slots and residencies set by the AMA in the 1990s would take a decade to increase the number of practicing doctors.
This means you’ll see the same increasing demand for nurse practitioners, making the nurse practitioner doctorate degree an excellent investment in your future. Federal legislation won’t affect state legislation, increasing the authority those completing online doctoral nursing programs have, for example, the ability to prescribe most medications or work without the supervision of a doctor in many situations.
Trump’s alternative to Obamacare would aim to retain the coverage for pre-existing conditions at the same general cost everyone else pays and provide coverage for young adults on parents’ plans until age 26. It replaces federal subsidies with federal tax credits and grants to states, though opening up state insurance markets to various forms of health insurance will also likely occur.
Sharon Rondeau has operated The Post & Email since April 2010, focusing on the Obama birth certificate investigation and other government corruption news. She has reported prolifically on constitutional violations within Tennessee’s prison and judicial systems.