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Trump's takes a remarkable turn to single-payer

Froma Harrop on

Hospitals struggling to treat waves of very sick people now face a new threat: millions of uninsured Americans pounding at their gates. How can the hospitals afford to treat them, even if they have the beds?

The obvious response was for President Donald Trump to open early enrollment in the federal Affordable Care Act marketplace. The 11 states that control their own Obamacare exchanges had already done that (rather than make people wait seven months for the official sign-in period). Insurers, providers and many Republicans expected Trump to take that step.

But surprise: President Donald Trump said he wouldn't open the ACA marketplace early. Instead, he would order the federal government to directly pay hospitals for care of uninsured novel coronavirus patients.

"You know what that's called?" a Republican lobbyist said to Politico. "That's called single payer."

How true. And how bizarre, given the president's known hostility toward socialized insurance (apart from the politically untouchable Medicare). On one hand, Trump may be a left-wing socialist commie in disguise. On the other, more likely hand, his single-payer initiative might be just a move in his game plan to erase Obamacare.

After all, opening the ACA exchanges early would have been admitting that Obamacare is needed. And Trump is still urging the U.S. Supreme Court to kill the ACA altogether. Trying to expand Obamacare and kill it at the same time could prove awkward.

 

Hospitals are not optimistic that Trump will pay them. They have questions: Will the money be taken out of the existing $100 billion fund to help get them through this crisis? If so, how much? Will it cover care for problems related to COVID-19 such as pneumonia? And how long will it take to build a new payment system?

Consider the strangeness of having the feds pick up the hospital bills for the coronavirus but not stage 3 lung cancer. But as Health and Human Services Secretary Alex Azar explains, "What President Trump is doing here with this money is an unprecedented disease-specific support of care."

Another benefit to hospitals, Azar added, is that the government would reimburse them faster than the insurers. Not exactly a thumbs-up for private coverage.

Obamacare's exchanges are, of course, the market-oriented approach that conservatives purport to prefer. They let the uninsured choose the level of private coverage they want -- with subsidies if they need them. And those who sign up are insured for heart attacks as well as the coronavirus.

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Copyright 2020 Creators Syndicate, Inc.
 

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