Like it or not President Trump continues to follow through on the policies and provisions he espoused during his campaign. On Thursday, the Republican blueprint for healthcare was released and in the coming weeks this document will be organized into a plan to repeal and replace Obamacare.
Central to the document is the elimination of the employer and individual mandate “taxes.” Importantly, the law seeks a transition from the existing program and I remain hopeful that behind the scenes, insurance carriers have somehow been convinced to go along with the plan.
Medicaid would be streamlined and narrowed, moving willing states to a block grant. Notably, those the HHS considers to be “able-bodied” Americans, who are capable of work, would no longer be eligible. The 31 states and D.C., which elected Medicaid expansion, will be given transitional funding.
Health savings account funding maximums would increase, along with allowances for catch-up contributions for both spouses, and HSAs would continue to include coverage for over-the-counter medications. And catastrophic plans would be supported not just for the young.
Those who are ineligible for employer or government programs would receive an age-, not income-based, monthly credit to support the purchase of individual market based coverage. And unused credits could be deposited into HSA accounts for future use.
In a concession to insurers, the plan advocates high-risk pools for the sick, which would ideally stabilize the market once credits are eliminated.
The document is short on details, like how it would be paid for, and in the coming weeks those will be revealed. But no one should be surprised – we saw it coming.
Strap in, the debate starts now.