The Washington PostDemocracy Dies in Darkness

Trump spokesman says Obamacare replacement will harness marketplace competition

Sean Spicer, President-elect Donald Trump's choice for White House press secretary, exits an elevator at Trump Tower in New York earlier this month. (Jabin Botsford/The Washington Post)

A spokesman for Donald Trump sought Monday to elaborate on the president-elect’s plans to replace the Affordable Care Act, vowing that the new administration would lower health-care costs by infusing more competition into the marketplace, including by allowing insurers to sell health plans across state lines.

Trump’s goal is “to get insurance for everybody through marketplace solutions, through bringing costs down, through negotiating with pharmaceutical companies, allowing competition over state lines," Sean Spicer, the incoming White House press secretary, said during an interview on NBC’s “Today” show.

Trump vows ‘insurance for everybody’ in Obamacare replacement plan

Spicer’s comments followed a weekend interview with The Washington Post in which Trump said that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also promising to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.

Trump declined to provide specifics during the weekend interview and Spicer offered few details either. But he did go one step further by saying Trump wants to make it easier to sell health plans across state lines.

Health insurance is regulated by states, and each state sets its own rules for health plans. Republicans have long favored the idea of selling insurance across state lines on the premise that this could lower prices. Opponents contend that it would deteriorate the quality of health plans, because insurance companies might choose to locate in the states with the weakest coverage requirements.

During his interview with The Post over the weekend, the president-elect said his replacement plan is “down to the final strokes.”

Trump is still largely talking about the ideas for insurance coverage that he touted during the campaign and that conservatives have long favored, with some exceptions.

Asked whether Trump’s replacement plan amounts to an expansion of government health care, Spicer insisted Monday it does not, saying access would be improved and costs would be driven down through marketplace competition.

“The competition is sorely missing,” Spicer said. “We’re not negotiating with drug manufacturers to drive the cost down. We’re not instilling a sense of competition to allow them to negotiate over state lines. There’s a lot of things missing which by their very nature would drive the cost down, and the beautiful thing about someone like Donald Trump is he comes in from a very successful business perspective. He knows how to negotiate great deals, and at this point, he can now use his negotiating skills to benefit the American people and give them a much better health-care system than they have.”

Trump’s declaration that his replacement plan is ready comes after many Republicans — moderates and conservatives — expressed anxiety last week about the party’s lack of a formal proposal as they held votes on starting the process of repealing Obamacare.

Amy Goldstein contributed to this report.