Trump lays out five principles for replacing Obamacare in his first speech to Congress
President Trump didn’t repeat his promise to deliver a “terrific” replacement for Obamacare within days Tuesday evening.
But the president did outline a series of “principles” that he said Congress should follow as it repeals the Affordable Care Act and develops an alternative.
Several are staples of conservative thinking on healthcare: restricting medical malpractice suits and allowing more sale of health insurance across state lines.
Neither idea has impressed many healthcare experts, most of whom say the proposals would have relatively little impact on reducing healthcare costs.
But Trump also appears to be staking out positions that may be more consequential.
He said healthcare legislation “should ensure that Americans with preexisting conditions have access to coverage,” a phrase that Republicans have often used to step back from the current law’s guarantee of coverage.
Many conservatives say that the federal government only must guarantee “access,” a distinction that critics note would justify an Obamacare replacement that does not cover as many people as the current law.
The Affordable Care Act has extended coverage to more than 20 million previously uninsured Americans.
Trump also called for tax credits to help Americans buy health coverage. That could put him at odds with conservative Republicans in Congress, who object to the current law’s system of subsidizing millions of Americans’ health insurance.
And the president said the federal government should give states “the resources and flexibility they need with Medicaid to make sure no one is left out.”
With that phrasing, Trump appears to be supporting longtime calls from Republicans for more flexibility to reshape Medicaid, including imposing work requirements and requiring Medicaid patients to pay more for their medical care.
But his reference to “resources” is less clear. Many Republican Medicaid proposals, including ones by House Speaker Paul D. Ryan and Trump’s health secretary, Tom Price, would slash federal support for the program.
Finally, Trump reiterated calls to make prescription drugs more affordable.
But he seemed to suggest the problem could be best addressed by speeding federal regulatory review of new drugs, not negotiating lower prices for seniors on Medicare, as he has proposed in the past.