One of the key issues being discussed at the Senate confirmation hearing on the nomination of Judge Amy Coney Barrett to the Supreme Court is the lawsuit challenging the constitutionality of ObamaCare. The high court is set to hear oral arguments in the case on Nov. 10 — just one week after Election Day.
President Trump has been calling for the repeal of ObamaCare since his 2016 election campaign. Democrats fear Barrett may give him the vote on the Supreme Court he needs to overturn the law, officially called the Affordable Care Act.
But there’s a lot more to the president’s health care record than his four-year battle against ObamaCare. In fact, the Trump administration has quietly done quite a bit to expand choice and affordability in health care.
Trump’s actions don’t lend themselves well to concise campaign talking points or tweets. But they’ve delivered real benefits for millions of Americans.
When Trump took office as president in January 2017, affordable health insurance was nearly impossible to come by for many Americans.
Premiums on the individual insurance market that year were more than double their pre-ObamaCare levels. Deductibles were on the rise, reaching $6,150 for the average bronze plan sold on the federal marketplace. Private insurers were fleeing the health care exchanges, leaving marketplace customers with a dwindling number of choices.
Perhaps most galling, people who found exchange plans unappealing or unaffordable — and went uninsured as a result — were charged a penalty under ObamaCare’s individual mandate.
The Trump administration understood that, absent full-scale reform, its goal should be to create as many affordable coverage options as possible while neutralizing ObamaCare’s worst provisions. On that front, the president has notched several victories.
The most obvious is the elimination of the individual mandate’s penalty as part of the 2017 tax reform law.
Less well-known is a 2018 rule that’s made it easier for Americans to use short-term health insurance plans as an alternative to exchange coverage. These policies aren’t subject to ObamaCare’s cost-inflating regulations — and are thus much cheaper than exchange plans.
It’s for this reason that, in ObamaCare’s early years, many Americans embraced short-term health insurance plans. Between 2013 and 2015, sales of the plans grew by around 150 percent.
The Obama administration believed that the growing popularity of short-term insurance plans was undermining exchange enrollment. So it issued a rule in 2016 that limited the duration of the plans to just 90 days and banned patients from renewing their coverage once it expired. The rule effectively cut off short-term plans as a viable substitute for exchange coverage.
But the move backfired. People didn’t begrudgingly go into the exchanges to purchase more expensive health insurance coverage. If they weren’t eligible for subsidized coverage, many simply went without insurance. Unsubsidized exchange enrollment plummeted 40 percent between 2016 and 2018.
Trump’s rule change is giving this group access once again to affordable coverage. According to a recent study by the Congressional Budget Office, an estimated 600,000 Americans ineligible for ObamaCare premium subsidies will move over to the short-term plans by 2028.
Trump’s expansion of health reimbursement arrangements is also worth celebrating. Until recently, these setups allowed employers to provide workers with pre-tax money to help cover out-of-pocket health costs.
Last year, the Trump administration allowed health reimbursement arrangement funds to be used by workers to purchase insurance coverage for themselves on the individual market. In effect, this policy enables employees to enjoy the same tax advantages as employers when buying health insurance. It also gives more Americans the freedom to secure coverage that is right for them, rather than whatever plan their employer happens to offer.
Further, the president has laid the groundwork for greater price transparency in our health system. One rule in the works would require insurance plans to disclose all prices and cost-sharing arrangements. A second would force hospitals to provide patients with itemized, easily searchable data about the prices of treatments and services.
By giving Americans the information they need to make cost-conscious health decisions, these policies have the potential to drive down prices and reduce health spending without sacrificing quality.
Ideas like this one are at the heart of Trump’s America First Healthcare Agenda, which he unveiled in a speech Sept. 24. The primary goal? To provide Americans with more health care options that will put patients and doctors back in control.
President Trump generally doesn’t shy away from informing people about his accomplishments. Yet he’s been oddly reticent to inform the public about his work making health care more affordable. If he hopes to retain the White House, that will have to change.