Throughout the 2016 election, President-elect Trump campaigned on promises that he was going to repeal the Affordable Care Act, widely known as Obamacare. While that promise was met with approval from the staunch Republicans who have opposed Obamacare at every step of the way, the 16.4 million Americans who wouldn’t have health care without the ACA weren’t so thrilled.
In response to the criticism, Trump changed his campaign rhetoric from simply repealing it to the “repeal and replace” claims that Republicans, led by House Speaker Paul Ryan, have advocated for since Obama’s accomplishment had his name tacked onto it. Now that Republicans actually have to specify what exactly repeal and replace means, it looks like Ryan and company really just want to rip off Obamacare and take credit for it.
As Trump tweets responses to any and all criticisms from Trump Tower, questions about health care have mostly fallen to Paul Ryan. Paul Ryan has claimed that Obamacare is causing Medicare to “go broke,” and that Medicaid is on “fiscal straits,” though Obamacare has actually increased funding for Medicare and the program isn’t expected to be under any more financial duress than it was before the ACA.
Ryan plans to make Medicare part of the replacement plan for Obamacare, one of several points on which Trump and Ryan disagree. Prior to the election, Medicare reform didn’t even garner a mention on his campaign website, though, likely due to Ryan’s influence, it is now under his list of health care priorities on his transition website.
In response to Ryan’s plans, experts are saying that the replacement health care plans under a Trump administration would look suspiciously like Obamacare. Conservative policy analyst Avik Roy even agreed that “the way it works is comparable to Obamacare,” including policies that would determine coverage under Medicare by income, with government subsidies for lower-income people.
Ryan has also included a public-private program in his replacement plans, despite the fact that Medicare is already a dual public-private program. The similarities don’t end there, either — in response to outcries over repealing the most popular parts of the ACA, including allowing children to remain on their parents’ insurance up to age 26, the Trump administration has stated that they will be incorporating those aspects of Obamacare into the “new” health care act as well.
As Trump and Ryan attempt to clarify how exactly the replacement health care plans will differ from Obamacare, the “repeal” portion of their plan seems to be just as ill thought out, particularly concerning when and how they would repeal Obamacare without costing millions of Americans their coverage. Plans to “repeal and replace” have stretched further and further ahead into the future, and in the meantime, Americans would be lucky if four years pass before the Trump administration figures out what it wants to do with healthcare.
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