TrumpCare: Making Health Care Great Again?

Finally, Trump issues some details on something.

In a campaign that’s been criticized for being long on rhetoric but short on specifics, every so often Donald Trump will put out an issue paper that at least signifies someone in his campaign is addressing issues dear to Republican voters. Earlier this week we learned what Trump would do with ObamaCare if elected — repeal it, just like all the other Republicans would.

But The Donald’s plan is interesting in that, while he vows, “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare,” he asks Congress to do some of the heavy lifting before he hits town. That may be a stretch if Trump loses the Senate for the GOP.

Reaction to the Trump plan has been mixed. Ed Morrissey at Hot Air called it “a mixed bag, but mostly positive.” Morrissey believes the sticking point may be Trump’s idea for importing drugs from overseas. And given Trump’s protectionist bent, there is a certain irony to his willingness to open up that particular market.

On the other hand — and perhaps not unexpectedly — Ramesh Ponnuru at National Review criticized Trump’s plan as “consistent with Trump’s rhetoric on health care in that it betrays little familiarity with health policy.” Last week, Ponnuru, writing at Bloomberg View, praised Marco Rubio for his ideas on the topic, which he said would “replace Obamacare with a health care market in which the government plays an enabling rather than a managerial role.”

(For comparison’s sake, Rubio described his plan last year, stressing he would use tax credits, regulatory reform and work to save and strengthen Medicare and Medicaid. John Kasich has also put up some broad ideas regarding his health care plan, much of it based on his policies in Ohio. Ted Cruz hasn’t yet made a specific proposal.)

One thing about Trump’s plan that may strike a chord among conservatives is the proposal to sell insurance across state lines, which is a common idea. (Trump liked it so much, he repeated the line about the state lines quite often at last week’s debate.) But Trump adds, “As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state.” The problem is that insurance companies tend to shy away from states with very restrictive requirements, meaning the competition won’t be there unless pressure is put on states to loosen their restrictions. If high-deductible catastrophic plans don’t meet state requirements, there’s little chance of saving money.

Trump is in favor of eliminating the individual mandate, but he also believes “we must make sure that no one slips through the cracks simply because they cannot afford insurance.” And, as he insisted, a Trump administration wouldn’t leave people “dying in the streets” — as if somehow other Republicans would. The goal of universal coverage was also the stated goal of ObamaCare, but Trump operates under the belief that younger people will be more interested in securing health savings accounts coupled with high-deductible plans if they aren’t forced into them. This may be the fatal flaw, since it’s the younger people not buying insurance (and instead paying a far more modest tax penalty) that is bankrupting ObamaCare.

In short, Trump is making a nod toward the free market with his rhetoric, but, like many of his other statements, his word is only as good as the freshness date before which he changes his mind and story again.

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