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Trumpcare Highlights: Where Healthcare Could Be Headed

donald-trumpTom Price (Republican Congressman from Georgia), an orthopedic surgeon, is Trump’s pick to lead the Department of Health and Human Services (HHS). In 2014, He authored the “Empowering Patients First Act”. Seema Verma (Founder and CEO of the consulting firm SVC, Inc.) is Trump’s choice to head the Centers for Medicare and Medicaid Services (CMS). Together, the 3 top players in the new administration taking office in January (Trump, Price and Verma) have authored some of the following thoughts and comments on how they would change the health care horizon:

  1. Repeal Obamacare and eliminate the Individual Mandate “as no person should be required to buy insurance unless he or she wants to”.
  2. Allow individuals to use and expand the use of Health Savings Accounts (HSAs). Accounts would become part of the individual’s estate and passed on to heirs. Because of the tax advantages of HSAs, young people should be attracted to them (essentially a health care 401k).
  3. Medicaid to be provided through “blockgrants” to each individual state. States will have the incentives to seek out and eliminate fraud, waste and abuse.
  4. Require all health care providers, payers (doctors and hospitals), to initiate “price transparency”. Hospital charges and providers services will be posted for public consumption.
  5. Modify existing laws to permit the sale of health plans across state lines, as long as they comply with state insurance requirements. This elevates carrier competition to drive costs down, as new carrier negotiations with hospital and doctor networks intensify.
  6. Remove barriers-of-entry for foreign importation of pharmaceuticals into the U.S. market. Allow citizens access to imported, safe and dependable pharma, again adding free-market competition to the industry.
  7. Provide refundable tax credits to subsidize the purchase of private health insurance which would be determined by age (and not income as it is currently determined). A sampling would be :
    • $900/year for children under 18
    • $1,200/year for individuals 18-35
    • $2,100/year for individuals 36-50
    • $3,000/year for individuals 51-64
  8. Place a “cap” on the tax-exclusion provision provided to employer-sponsored health plans at $8,000 for single-coverage, and $20,000 for family coverage. So a business can no longer gain tax advantages in providing out-of-cost plans and gaining tax write-offs. This would replace the lost Cadillac Tax revenue.
  9. A one-time open enrollment for all. If you have maintained continuous coverage in the previous 18 months, then no previous existing conditions can exist. If you’ve not maintained 18 months of continuous coverage, then you can be denied coverage on any pre-existing condition for a period of 18 months (keeping in mind that the policy and coverages are still guarantee issued). Insurers can charge more for those with pre-existing conditions, possibly.
  10. Establish the creation of state “high risk pools”. The federal government will provide funding, but the program will be run by the state.
  11. Carriers (insurers) will be unrestricted on plan design changes in each state (eliminating essential health benefits, “metal plans”, and premium ratings based only upon age, zip, and tobacco usage). More of a “permissive” regulatory environment.
  12. No price constraints based upon age (currently at 3:1).
  13. Accelerate the work of “Health Information Technology” (HIT). The promotion of health information “interoperability” and prohibition of health information blocking practices. These practices would include: privacy and security, patient access to their own health information, promoting care coordination between doctors and hospitals, improving continuity of care, reducing medical errors, accurate patient matching and managing chronic conditions.
  14. Cyber security enhancement to prevent cyberterrorism that goes well beyond hacking of Protected Health Information (PHI).
  15. Possible creation of a “voucher“ system to the current Medicare program.