Trump’s Healthcare Rollercoaster: Rates Go Up, Coverage Goes Down

Republican attacks on the healthcare system are beginning to take a grim toll on the health and pocketbooks of Americans. While Republicans failed to deliver on their campaign promise to repeal the Affordable Care Act, they have weakened and undermined ACA healthcare protections and financial supports. In 2017, for the first time since 2013 when the ACA took effect, the propotion of uninsured Americans rose. Now as the season for state regulatory review begins, there are clear signs that health insurance premiums are going up in 2019 - in many cases way up in large part due to the repeal of the individual mandate. Meanwhile, benefits and coverage are going down. The Republican assault on American health care is beginning to produce the expected poisonous results. At the end of 2017, for the first time in a decade, Americans registered a broad decline in the well being of their citizens.

Donald Trump and the Republicans in Congress took power promising to repeal the Affordable Care Act (ACA) and to replace it with something “much, much better.” In spite of having control of both houses of Congress the effort to repeal the ACA failed largely because the law is effective and its provisions are popular. Rather than trying to improve on the law in the areas where everyone agreed it needed improvement, Trump and the Republicans have devised ways to undermine its effectiveness and to exclude people from coverage. In short, for these Republicans sabotage is preferable to working with Democrats toward an effective compromise that would improve our healthcare system. 

This sabotage is having real effects on Americans that are now becoming clear. In 2017, 21 states reported a decline in the well being of their citizens. A greater number of states reported a decline in well being in 2017 than during the Great Recession of 2008. Indeed, for the first time ever, NO state reported a meaningful improvement in this important measure. 

The proportion of uninsured Americans has risen since reaching its lowest level ever just before Trump took office. The rate had dropped from 18% in 2013 as the ACA took effect to under 11% at the end of 2016. Since then the rate has steadily risen to 12.3%. These are millions of Americans who are no longer covered. That number is poised to climb dramatically in 2019 as much higher health insurance premiums take effect. These new insurance price hikes are the direct result of the actions taken by Congressional Republicans and the Trump’s administration.

Meanwhile, benefits are being cut back in several important areas and the administration is protecting price gouging drug companies. 

The Trump administration has promulgated rules to allow insurers to offer “skinny” health plans that do not include the benefits initially mandated under the ACA. People buying these “skinny plans” are spending less but getting little or no real benefits. 

The Trump administration with Republican Congressional backing is now allowing employers to eliminate a variety of reproductive services, including contraception for women, from their coverage. This is done in the name of the employers’religious freedom with no concern for the employees’ health. 

The Department of Health and Human Services is seeking to impose work requirements on Medicare recipients which do nothing to help low income people find and keep jobs, but creates barriers to receiving needed health care by people with no other options.

A recent proposal to impose punitive work requirements on the recipients of health care through the Indian Health Service is similarly pointless and has the added effect of usurping the governing powers of native Tribal governments.

And, most recently, Trump reversed himself on a campaign promise to allow the federal government to negotiate for lower drug prices for Medicare and Medicaid.

This is far from the “much, much better” system of healthcare that Trump and the Republicans promised us. The Republican prescriptions for healthcare are a poison that is just beginning to take hold.

Call To Action

Call your Representatives and Senators and insist that they:

  1. take steps to stop the dramatic rise of costs and the falling number of Americans with insurance;
  2. protect the health care guarantees of minimum effective coverage - including reproductive care - promised under the Affordable Care Act;
  3. push Trump to keep his campaign promise to allow the Federal government and Medicare to negotiate for lower drug prices; and
  4. keep long standing health care protections for Native Americans through the Indian Health Service.