Meanwhile, Secretary of Health and Human Services Alex Azar said Trump will not offer an Obamacare replacement for a Supreme Court ruling on the law, which is unlikely before the election. Republican lawmakers, who attempted the first year of Trump’s presidency and failed to assassinate Obamacare, largely distance themselves from Trump’s embrace of the Supreme Court’s challenge that threatens the survival of the law.
Trump has offered little assurance that there is a strategy to maintain healthcare coverage for the more than 20 million that would lose if the Supreme Court ruled against Obamacare. The President has repeatedly pledged to provide cheaper and better coverage that protects people with pre-existing conditions, but those promises are undermined by the party’s decade-long struggle to agree on a replacement.
Republican policy experts say the GOP has continued to seize a health care platform during the Corona virus crisis when Democrats dominate on an issue that is once again top priority among voters.
What is the Republican health care agenda now? There is no consensus on this, nor was there a consensus in 2017, which is a big part of why withdrawal and replacement failed, ”said conservative health policy expert Avik Roy, who leads the Equal Opportunities Research Foundation, a free market think tank.
Conservatives applaud Trump’s steps to curb Medicaid and undermine Obamacare, saying they would cut costs and provide more affordable health insurance. But they will provide more attack food for the Democrats, who used healthcare to increase their fortunes in the 2018 midterm elections, and are eager to highlight Trump’s agenda this fall.
“It’s a more dangerous agenda than ever, it’s getting more and more toxic to voters, and we hold Republicans accountable,” Stewart Boss, spokesman for the Democratic Senatorial Campaign Committee, wrote in an email.
Polls show that Democrats have a comfortable lead over republicans in health care, and Trump continues to survey his approach to the worst health crisis in a century. An election message for the election year that House Democrats adopted two weeks ago, looking for a contrast to Trump’s health movements, would expand Obamacare’s insurance subsidies and also encourage the remaining 13 Medicaid expansion holding states to join the program.
A White House spokesperson defended Trump’s attacks on Obamacare, highlighting the President’s other recent health initiatives that were more twofold attractive, such as limiting insulin costs for seniors and expanding telecare capabilities during the pandemic.
“A global pandemic does not change what Americans know: Obamacare has been an illegal failure and further illustrates the need to focus on patient care,” said its spokesperson, Judd Deere. “It limits patient choice, forces Americans to buy prohibitive plans, and restricts patients with pre-existing high-risk conditions from accessing the doctors and hospitals they need.”
Trump himself has been trying to grab other health care reports in recent weeks. After a federal judge confirmed the administration’s new claim last month that hospitals reveal secret prices they negotiate with health insurers, Trump claimed on Twitter that the decision was “Greater than the care itself” – a clear reference to the Affordable Care Act. The requirement is not expected to come into effect until January, and it is questionable whether the new transparency rule will lower health care prices, as supporters claim. Hospitals are still trying to overturn the mandate for courts.
The President has also recently scolded Democrats over drug pricing after discussions about bipartisan Senate law broke up, but fully embraced the plan. Pharmaceutical companies, meanwhile, raised the prices of hundreds of drugs during the pandemic, defying Trump’s tough talk against the industry.
Some conservatives have argued that the pandemic has made their case for a Medicaid overhaul even more urgent. State budgets have been hit by lost earnings during shutdowns, and some have already cut Medicaid spending, which is usually one of their largest budget lines. But they recognize the difficult view of the agenda at the moment.
“We are a few months ahead of an election, so political factors are on everyone’s mind. And you know, how do the media report things? The media tends to report Republican health plans as bad in an effort to reduce coverage, weaken the safety net, and so Republicans are aware of that, ”said Brian Blase, a former Trump assistant who helped develop the government’s alternatives to Obamacare coverage.
But Trump’s biggest idea for Medicaid – granting part of Medicaid spending for the first time in the program’s 55-year history – has already been viewed skeptically by many Republican governors, despite long-term conservative support for the idea. Rather than receiving an open-ended payment based on need, states would be given a lump sum and more freedom from many program requirements. Proponents of the idea say states can better manage their Medicaid programs, but critics warn that it leaves states with no choice but to cut enrollment and services in times of economic distress, as much of the country is now experiencing.
“The risk to states from a Medicaid block grant has always been unexpected events that have increased healthcare or enrollment costs,” said Larry Levitt, an executive vice president of the Kaiser Family Foundation. “The double blow from a pandemic and economic crisis is likely to give states a break.”
The pandemic is now expanding the use of the safety net. More people who lost workplace health insurance have signed up for Obamacare plans, although Trump has resisted reopening health insurance marketplaces in the broader sense to the uninsured. The federal government is temporarily putting more money into Medicaid programs as enrollment is expected to increase during the pandemic, and states should not cut their Medicaid roles during the coronavirus emergency.
Some Republican lawmakers say they don’t give up their plans to curb Medicaid and Obamacare, but put them on hold.
The Republican Study Commission, the policy department of conservative legislators, is working on the second phase of a 58-page framework for an Obamacare alternative released last fall. The pandemic has delayed planning for completion of the plan, a spokesperson said.
Senator Bill Cassidy, a Louisiana Republican who has prepared a replacement plan for Obamacare with an option for a Medicaid block grant, said there will be an opportunity to review major health programs after the pandemic.
“When people are under pressure, they really don’t like change,” said Cassidy. “But if things go better, they have a little more comfort when changing.”