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Trump promises 'phenomenal' health plan. What might that mean?

Julie Appleby, Kaiser Health News on

Published in Health & Fitness

Supporters and critics say likely elements are already in plain sight, both in executive actions and proposals in the president's budget as well as a little-noticed white paper released late last year.

The president has won praise from both conservatives and liberals for such things as his proposals to require hospitals to post their actual, negotiated prices, and some strategies to lower drug prices. But legal battles within the health industry could thwart such initiatives.

On these topics, "a lot of what they've proposed has been pretty smart," said Shawn Gremminger, senior director of federal relations at the liberal Families USA advocacy group.

Still, Gremminger points to other administration actions -- loosening rules on health insurers to allow sales of what critics call "junk" insurance because they don't have all the consumer protections of ACA policies, or promoting work requirements for Medicaid recipients -- as strong hints to what might be in any eventual election-related plan.

"I think what we'll see is a lot of that same sort of stuff, warmed over and put into a new package," Gremminger said. "We fully expect it will include a lot of really terrible ideas."

For other policy clues, some advisers, like Brian Blase, a former special assistant to the president at the National Economic Council, said look no further than that little-noticed 2018 interagency report.

 

The 114-page document includes more than two dozen recommendations that broadly focus on loosening federal and state regulations, limiting hospital and insurer market power and prompting patients to be more price-conscious shoppers.

Many are long-standing Republican free-market favorites, such as increasing the use of health savings accounts, which allow consumers to set aside money, tax-free, to cover medical expenses. Other ideas are not typically associated with the GOP, such as increased federal scrutiny of hospital and insurer mergers, which have driven up prices.

The paper also calls for less restrictive rules for the Medicare Advantage plans that offer an alternative to the traditional fee-for-service Medicare. It would allow the advantage program to have smaller networks of doctors and hospitals -- presumably ones that agreed to charge less.

"The administration knows where it is going on health care," Blase said.

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