What health care coverage will look like under President Donald J. Trump can only be speculated. We can be sure parts of the Affordable Care Act will be unwound, but whether the whole health care program will go away in time won’t be known for several years.
What we do know, from an analysis the Obama administration probably hated to see released on Friday, is that United States health care spending picked up last year and is now nearly $10,000 per person, and the government became the largest payer for health care in 2015.
The study indicated the 5.8 percent spending increase is largely due to the additional number of people who signed up for the Affordable Care Act or acquired health care through an expansion of the Medicaid program in more than 30 states and the District of Columbia.
The biggest driver in the mix, according to the study, was a 7.2 percent rise in spending for private insurance. And, as many health care insurance clients are aware, most of the private insurance companies continue to lose millions of dollars in offering insurance through the Affordable Health Care Act.
Meanwhile, Medicaid expenditures for the poor grew 9.7 percent, prescription drugs rose 9.0 percent, clinical services jumped 6.3 percent, hospital costs increased 5.6 percent and Medicare spending on the elderly climbed 4.5 percent.
Health care costs are now 17.8 percent of the country’s Gross Domestic Product, a bump up from 17.4 percent in 2014.
Under Trump, removing the Affordable Care Act’s mandates conceivably should reduce premiums. If all of the insured don’t have to pay for things they don’t need but must have, from pediatric dental care to speech-language pathology, it stands to reason costs will go down.
Subsidies for qualified Americans enrolled in the federal and state exchanges, under plans offered by Republicans in the recent past, would be rolled into tax credits which could be used by consumers to find the plan that best suits their needs and wallets. Additional funds could be put into a flexible, tax-free health savings account, again allowing the consumer to be the driver.
Trump also has said he wants to keep provisions of the Affordable Care Act – provisions Republicans called for years ago – that allow children to stay on their parents’ insurance plans until age 26 and the inability to deny coverage based on pre-existing conditions.
Six years ago, President Obama told us we could keep our doctors and our insurance plans and that our health care costs would decrease if we only went along with his program. Congress (the Democrats, not Republicans) did go along with those plans, but Obama couldn’t keep those promises, if he ever intended to.
History will judge Trump on what replaces the Affordable Care Act, a plan he said as recently as last month would be “better health care, much better, for less money.”
We hope he’ll do what Obama couldn’t.