Remember when popular vote loser Donald Trump promised "insurance for everybody"? You should, it was just several weeks ago. Seems like one of the things Trump has found so mind-boggling complicated in healthcare is navigating the chaotic waters of the Republican congress.
Because it's no longer insurance for everybody, it's "expand choice, increase access, lower costs." Access is not insurance. But access is the now Trump's low bar for a plan, meaning he's pretty much entirely capitulated to Paul Ryan. Here's the rest of his "vision":
First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges.
Once again, access to coverage is no guarantee of coverage for this population, all all 52 million of them living with everything from cancer to acne. That's 1 in 4 Americans who no longer have a guarantee that they can indeed keep their health insurance.
Secondly, we should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts—but it must be the plan they want, not the plan forced on them by the Government.
First, a huge chunk of the House Republican maniac caucus has rejected tax credits. Not going to happen. Second, Health Savings Accounts are just another tax break for the wealthy. Most of the people who have to worry about how to afford medical care don't have a lot of free money hanging around to put into an HSA, and certainly not enough to pay for a major emergency. It's not insurance.
Thirdly, we should give our great State Governors the resources and flexibility they need with Medicaid to make sure no one is left out.
Flexibility is code for "block grant" which is code for Republican governors can punish and humiliate poor people to the maximum of their sick desire to do so.
Fourthly, we should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance—and work to bring down the artificially high price of drugs and bring them down immediately.
Great. Tort reform. You knew that old saw had to be there somewhere. Prescription drug price reduction? That's the one thing in all of this that you might get Democratic help on, but it was also kind of a throw-away here.
Finally, the time has come to give Americans the freedom to purchase health insurance across State lines—creating a truly competitive national marketplace that will bring cost way down and provide far better care.
Because this bad idea will never die. This is a gift to health insurers—not consumers. It would allow insurance companies to flock to states that had the most lax consumer protections. It would allow more junk insurance plans.
Trump has capitulated to Paul Ryan on Obamacare repeal, completely. That's probably because he's just discovered healthcare is really complicated so it's just easier to let someone else figure it out.