BOSTON (CBS) – Last night, finally, President Trump and his advisors publicly acknowledged what had been obvious for weeks – Twitter insults, media-bashing and temper tantrums weren’t going to help him improve on the worst early approval numbers in modern American history.
So they wrote him a conventional presidential laundry list of conservative policy prescriptions, he delivered it well, and a polling bounce is surely on its way. We’ll see if this nod to tradition – and its tacit acknowledgement that his stunning election win didn’t quite mean he’s reinvented the political wheel – is now the new Trump normal.
But in the meantime, we are left to do what we always have to do after presidents deliver these long-winded lists of vague promises – figure out if there’s any there there.
Let’s focus on health care, one of the few subjects where the president went beyond utter boilerplate. Conveniently, Politico the other day published a draft copy of an Obamacare replacement bill that’s circulating in the House. We asked Jon Kingsdale, the health care expert chosen by then-Gov. Mitt Romney to be the founding director of the state’s Health Care Connector, to analyze what’s in it, and then compared that with what Trump was touting last night.
“The way to make health insurance available to everyone is to lower the cost of health insurance, and that is what we are going to do,” said Trump in his address.
But Kingsdale notes that the draft GOP plan proposes deep spending cuts in Medicaid that will boost costs for many consumers. “The Republicans seem to be dedicated to reducing the federal financial commitment, which is going to make it much more difficult for individuals to afford to buy insurance if they’re low-income, and for states to maintain generous Medicaid eligibility standards.”
Instead, the plan offers tax credits to help people afford their coverage. “We should help Americans purchase their own coverage, through the use of tax credits,” Trump said.
That’s an idea Kingsdale says has merit in theory, but check out the caps on those credits – $4,000 for those over 60 years old, just about enough to get a broken bone fixed. For seniors under this plan, says Kingsdale, “the increase in premiums could be just humongous, on the order of five- to ten-fold, just because of the reduction in credits they would be eligible for.”
Trump last night: “Mandating every American to buy government-approved health insurance was never the right solution for our country.”
But the GOP plan slaps consumers with a big penalty if they don’t maintain continuous coverage, a signal that for all their bluster, Republicans agree with Obamacare’s contention that unwilling consumers have to be forced to pony up to make the system financially viable. “Replace and rename” is Kingsdale’s sarcastic description of this.
And yes, a slew of unpopular Obamacare taxes are gone in this draft version of Trumpcare. But the infamous “Cadillac tax” on the employer-based plans that most of the insured have lives on.
Bottom line – your health care bills are going up under Trumpcare, big league. “Either that,” says Kingsdale, “or we’re gonna have to confront some very very difficult choices about who gets benefits.”