Though President Trump has called the dismantling of the Affordable Care Act his top domestic priority, his remarks about health care came deep into his address to Congress. Largely repeating what he has been saying since his election, the president spoke in broad terms about longtime staples of GOP thinking on how to shift the nation’s health-care system.
Trump laid out what he called the principles that should guide Congress in working to “save Americans from this imploding Obamacare disaster.” He reiterated his position that people with preexisting medical problems should have access to insurance. He did not, however, mention an idea popular among Republicans to rely on state-level “risk pools” for those people, instead of the ACA’s rule that insurers may not turn them away or charge them more.
The president also endorsed federal tax credits instead of the current subsidies available to more than four-fifths of consumers buying health plans on ACA marketplaces. And he repeated his support for an expansion of health savings accounts. He spoke of giving states “the resources and flexibility they need with Medicaid” but did not say whether he preferred turning the program into a system of block grants to states or a cap for each person in the program – a debate underway on Capitol Hill.
He embraced a favorite cause of his new health and human services secretary, Tom Price, calling for unspecified changes to medical malpractice laws. In addition, he urged “work to bring down the artificially high price of drugs,” without specifying an approach he has mentioned recently: giving the government greater power to negotiate with pharmaceutical companies the prices of drugs in public insurance programs.