Trump Has A Healthcare Plan? Like His Gun Safety Plan?

Kevin Drum and I were being treated at City of Hope for similar cancers at the same time. I'm confident that he-- unlike many members of Congress-- understands healthcare policy and the importance of Medicare for All. About a week ago, Mother Jones ran an essay by Kevin, Trump Health Care Strategy: Pretend to Have a Plan. Referencing a report from the Washington Post, he wrote that "Apparently Donald Trump plans to take his usual sober and considered approach to health care policy during campaign season:

White House advisers, scrambling to create a health-care agenda for President Trump to promote on the campaign trail, are meeting at least daily with the aim of rolling out a measure every two to three weeks until the 2020 election.

...Some, however, are doubtful a flurry of executive orders and new regulations would have an immediate effect on consumers’ pocketbooks. What is clear is that the approach, which includes White House support for a bipartisan Senate bill to cap Medicare drug price increases to the rate of inflation, is putting congressional Republicans in a tough spot: Embrace Trump’s agenda and abandon conservative precepts about interference in the marketplace, or buck the president on one of his top priorities.

...One lobbyist, who spoke on the condition of anonymity, described being stunned at a recent White House meeting when Domestic Policy Council Director Joe Grogan said the administration would not let Democrats run to the president’s left on lowering the prices of prescription medicines. In another tense meeting, top pharmaceutical executives were told bluntly “it wasn’t in the industry’s best interests” to block the bipartisan Senate bill backed by Trump. If it failed, they were told, they’d see “the president of the United States negotiating with Nancy Pelosi [on allowing the government to negotiate drug prices in Medicare],” said a person familiar with the meeting.

Uh huh. That’s a tough one. Should Republicans blithely abandon their principles and do what Trump wants or-- or what?

Of course, this isn’t a matter of sitting back and letting Trump attack brown or black or yellow people. This is a matter of by god interference with corporate interests, which really does put Republicans in a tough spot. They’re perfectly happy to let Trump tear into America’s oldest racial wounds, but reducing the profits of pharmaceutical companies by a few points? That’s a genuine chin scratcher. What’s a Republican to do?

Yesterday, Wall Street Journal reporters Stephanie Armour and Andrew Restuccia wrote that the White House will roll something out as a healthcare plan next month. Remember when Trump promised to create a healthcare utopia? A plan with heart? "i'm going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of-- much better than they're taken care of now." Don't remember? Watch:



Trump has done nothing... other than try to abolish Obamacare and cut Medicare and Medicaid. Now he wants a cohesive stacks of lies he can use on the campaign trail to contrast to Medicare-For-All. "Elements of the plan," wrote Armour and Restuccia, "could include providing coverage for people with pre-existing conditions, the people said, and spurring the sale of insurance across state lines. Other provisions being discussed include giving states more flexibility, expanding health savings accounts, linking price transparency to quality metrics, and more insurance options for consumers, they said. The plan would include a number of new elements that haven't yet been released, one person familiar with the work said. White House officials stressed that the plans haven't been completed, and some close to the president have privately expressed skepticism. One former White House official raised the possibility that the plan may not materialize this fall if Mr. Trump second-guesses the effort. The administration is also still weighing how specific the plan should be, the people familiar with the plan said, and the ideas have yet to get Mr. Trump’s sign off."

Kellyanne Conway, a senior adviser to the president who is involved in the discussions, met recently with House Republicans to brief them on the progress of the administration’s efforts, two people present said. She stressed that the administration’s plan would protect pre-existing conditions and she reviewed possible legal outcomes in the lawsuit to strike down the ACA. She is planning to brief Senate Republicans after they return from their August recess.

The push to put out a plan, which has already involved months of behind-the-scenes work, underscores growing concern on Mr. Trump’s team that the president could be vulnerable on health care. A recent Fox News poll of registered voters found Democrats had a 14-point advantage over Republicans on which party would do a better job handling the issue.

The administration is backing a lawsuit from GOP-led states to strike down the ACA, a stance that leaves Mr. Trump open to attacks from Democratic presidential candidates who say he is a threat to coverage.

“We are the Democrats. We are not about trying to take away health care from anyone,” Sen. Elizabeth Warren of Massachusetts said in the second Democratic debate in Detroit this week. “That’s what the Republicans are trying to do.”

The case may not be fully resolved until next year, placing health care at the center of the 2020 presidential campaign. An estimated 20 million people have gained coverage because of the ACA, and more than 100 million people with existing medical conditions could see their coverage lost or become more expensive if the law is struck down.

The White House has already released initiatives or been working on regulations that would accomplish some of the goals that could be in the president’s plan. But his fall proposal, if released, could go further-- for example, calling for state or state and federal high-risk pools, which aim to provide coverage to people who can’t get insurance because of expensive pre-existing health conditions, according to one person familiar with the planning.

“They definitely want to show they’re protecting pre-existing conditions,” said one GOP Hill staffer familiar with the discussions.

Parts of the plan would probably require congressional action, which is unlikely because the House and Senate remain divided.

The plan could call for grants to states to establish high-risk pools or programs that pay a portion of high-cost claims to buffer insurers and help drive down premiums. High-risk pools were used by more than 30 states and covered more than 200,000 people before the ACA, but some people had trouble getting coverage as states capped enrollment amid funding pressures.

The return of high-risk pools has been a longtime Republican goal; House Republicans pushed for the creation of a $15 billion federal high-risk pool in their proposals to replace the ACA. Critics say they cost too much money and have a long history of problems.

Mr. Trump may also lay out new strategies to jump start the sale of insurance across state lines, an idea he included in his 2016 campaign platform. The Centers for Medicare and Medicaid Service in March sought public input on how to eliminate barriers to such sales, which are already permitted, but have had few takers. Mr. Trump has also said he wants to let people on Medicare contribute to health savings accounts.

The proposal could also call for more action to link price information in health care to quality. Actions to provide more alternative forms of insurance that don’t comply with ACA regulations and consumer protections are also being discussed, one person familiar with the planning said.

The tentative release of a more complete plan in September is part of a broader strategy ahead of the 2020 election. The White House is planning to ramp up Mr. Trump’s speeches and actions on health care this fall because polls show it is a top issue for voters. The administration has already unveiled new efforts on a range of health-related issues, from improving kidney health to making it easier to import prescription drugs from other countries.

But skepticism abounds because Mr. Trump has repeatedly promised a health plan without delivering one. During the GOP push to repeal the ACA in 2017, he said he was close to finishing a plan that aimed to provide “insurance for everybody.”

Fault lines have emerged within the White House over how to accomplish aspects of the plan and how specific to be largely because of concerns it could open Mr. Trump up to attacks from Democratic presidential candidates, according to two people familiar with the discussions.

Yet allies of Mr. Trump believe it would give a boost to the president even though Congress is unlikely to take action on any of the ideas that require legislation.

At the White House, regular meetings on broad health-care strategy are being led by Domestic Policy Council Director Joe Grogan, with participation from Centers for Medicare and Medicaid Services head Seema Verma, Health and Human Services Department officials, and senior aides from the National Economic Council, Council of Economic Advisers and other White House offices, according to people involved in the talks.

Progressives expand healthcare; conservatives constrict it and block it. That's how it's always been and how it still is. If healthcare is important to you, never vote for a Republican and never vote for a Blue Dog or a New Dem. They're the enemy. If you click on the thermometer on the right, you'll find a list of progressive Democrats running for House seats, all of whom are campaigning on Medicare-For-All.

Marqus Cole is the strongest progressive running for the open congressional seat in the suburbs north of Georgia (GA-07) and one of the issues he's campaigning on is Medicare-for-All. This morning he told me that this week "here in Georgia we found out the 'Emperor had no clothes' the whole time when Governor Kemp's 'plan' to not cover all Georgians got shot down by the Trump Administration. Don't believe me? The major paper in town, the Atlanta Journal Constitution, had this to say about Georgia healthcare: 'Kemp’s plan for Georgia is still unknown at this point... [27%] of Georgians ages 19 to 34 are uninsured, one of the worst rates in the nation.' Much like the current administration, here in Georgia the plan for Georgia is still unknown while people go without access to basic affordable healthcare. Enough is enough. I'm heading to DC to fight for my neighbors here in Georgia and all around the country. We. Need. Healthcare. For. Everyone! Republicans like Rob Woodall, and those in his party trying to replace him, are on record for wanting to go back to the crazy world of pre-existing conditions, young adults without health care, and birth control that doesn't come standard. With a Democratic Congress and President we will make our first task ensuring Healthcare-for-all."

Shear across the country, in Oregon, Mark Gamba is thinking much the same way. "Here we are, the richest nation on the planet and we spend more per-capita than any other country in the world on healthcare, and yet out of the 11 top industrialized nations we rank number 11 in health outcomes. Not because our doctors, nurses and hospitals aren't outstanding-- they are-- it's just that millions of Americans can't access that outstanding health care, either because they can't afford health insurance or their deductibles are so high they can't access the care without going bankrupt. Republicans and corporate Democrats say it's 'too hard' or 'too expensive' to provide Universal Healthcare to all Americans and I say: That's B.S.! You are telling me that America isn't smart enough to accomplish what every other civilized nation on earth has managed to pull off? I wholeheartedly disagree. I know we can do it, and I know we can do it better than anyone else has done it because we ARE Americans. We just have to decide that it's more important to provide quality healthcare to all of our people for less money than it is for insurance companies and pharmaceutical companies to reap massive profits by denying us care and addicting us to opioids."