The House Speaker wants Obamacare dead. The House Budget Chairman — a leading candidate for HHS secretary — wants Medicare reform. But all the focus on Republicans’ health strategies is ignoring the biggest elephant in the room: Donald Trump, a president-elect who’s spent more than a year bucking congressional Republicans — and may not share their priorities, two leading conservative thinkers tell POLITICO’s “Pulse Check” podcast.
“For all the times that the president-elect has expressed his desire to repeal and replace Obamacare … [he] campaigned on universal coverage,” said Avik Roy of the Foundation for Research on Equal Opportunity. “That’s a very different set of principles … than you might expect from a generic Republican president-elect.”
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Healthcare is the top issue Americans want Donald Trump to address during his first 100 days in the White House, according to a Reuters/Ipsos poll released on Thursday, an apparent rebuke of outgoing President Barack Obama’s signature reform, Obamacare.
Some 21 percent of Americans want Trump to focus on the healthcare system when he enters the White House on Jan. 20, according to the Nov. 9-14 poll, conducted in the week after the Republican won the U.S. presidential election.
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But it is absolutely possible to craft a health-reform agenda that conforms to Trump’s core policy principles: (1) repealing and replacing Obamacare; (2) near-universal coverage; (3) lower health insurance premiums. As a bonus, these goals can be achieved by a plan that reduces federal spending, cuts taxes, and improves health outcomes for the poor.
Few would have predicted that Donald Trump could be a more successful health reformer than Barack Obama. But if he can get over a few important hurdles, it could very well end up being true.
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House Republicans and Vice President-elect Mike Pence on Thursday agreed on a plan to punt the government funding debate into early next year and begin preparations to repeal Obamacare.
Emerging from their meeting with Pence in the Capitol, House GOP lawmakers unified behind a continuing resolution that would extend government funding, set to expire on Dec. 9, through March.
“I think the main reason was the Trump admin had a desire to have an input on what’s in that spending bill when they take office,” House Appropriations Committee Chairman Hal Rogers (R-Ky.) told reporters after the meeting.
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President-elect Trump has made waves by saying that though he plans to repeal Obamacare, he wants to keep the aspect of it that bans coverage for those with pre-existing conditions. But this is not possible without broader changes to the healthcare system.
The pre-existing condition ban is ultimately one of the primary drivers of the premium hikes we’re seeing within Obamacare. The reason is that with insurers forced to offer coverage to anybody who applies, they incur higher medical costs, and they thus require more signups from younger and healthier people — but those signups aren’t materializing in a large enough volume to offset costs.
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Republicans on Capitol Hill are growing confident that they can begin to repeal Obamacare once President-elect Donald Trump is sworn in, along with a pledge to replace it later.
“We have an Obamacare emergency right now,” said Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate HELP Committee. “I think we could move forward in January on some aspects of repeal but we need to make sure that we are helping people and that we do no harm.”
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Congressional Republicans may be mulling a plan to repeal Obamacare before President-elect Trump takes office, a top GOP leader said Wednesday.
“Nothing has been decided but that is certainly one of the options,” Senate Majority Whip John Cornyn, R-Texas, told reporters after a closed-door GOP meeting on Wednesday.
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Virtually every Republican member of Congress who has been interviewed on TV has assured the national viewing audience that a top priority come January will be to repeal Obamacare. They make it sound easy. It is easy. At least defunding Obamacare is easy. And without any money to spend, what we call Obamacare would wither on the vine in short order.
Congress has already done this once. A procedure known as “reconciliation” deals with budget matters and it can’t be filibustered. That means if Republicans all vote in lock step the Democrats can’t stop them. Last year, Republicans in the House and the Senate voted to take all they money out of Obamacare through their reconciliation bill. The bill did not repeal the Obamacare mandates or Obamacare regulations because those are non-budget matters. But with no money to spend, all those mandates and regulations aren’t worth the paper they are written on.
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Two top House Republicans on health policy reiterated promises Monday to replace the Affordable Care Act after repealing it.
Rep. John Shimkus (R-Ill.), who is vying to lead the Energy and Commerce Committee next year, said the House GOP’s “Better Way” health plan will be the starting point for reform efforts. He referenced high-risk pools as the best way to require insurers to cover pre-existing conditions without having a mandate to purchase plans. Tax credits would help people afford coverage, he said.
“We just want to bring more choices, more competition,” Shimkus said. “Competition drives higher quality, lower cost. Always does, always will.”
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Throughout the campaign, President-Elect Donald Trump’s entire health message consisted of promising to repeal the Affordable Care Act.
That remains difficult with Democrats still commanding enough power in the Senate to block the 60 votes needed for a full repeal. Republicans could use fast-track budget authority to make some major changes to the law, although that could take some time. In the short term, however, Trump could use executive power to make some major changes on his own.
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