Obamacare’s fate appears bleak in new Trump administration

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Indications continue to grow that action will be taken to undo President Obama’s signature policy achievement, the Affordable Care Act, with the health coverage of more than 20 million Americans hanging in the balance.

Republican House and Senate leaders—emboldened by election results in which they retained control of both chambers—wasted no time indicating that that they intend to work with President-elect Donald Trump early in his new administration to repeal and replace Obamacare.

“This is a bad piece of legislation, among many bad pieces of legislation, passed in the first two years of the Obama presidency,” Senate Majority Leader Mitch McConnell (R-Ky.) told reporters on Wednesday. “Every single Republican thought Obamacare was a mistake without exception—that’s still our view, and you can expect us with a new President, who has the same view, to address that issue.”

McConnell added that, “The sooner we can go in a different direction the better.”

Clearly, the Trump White House and GOP leaders in the House and Senate will need to jointly work on legislation that not only repeals Obamacare but replaces it with what they consider to be a better solution. However, what ultimately replaces the ACA is still uncertain.

Also See: Replacing ACA—easily said, not easily done

Earlier this year, the Trump campaign issued a policy paper outlining several healthcare reforms that “should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.”

Among Trump’s policy recommendations, he has called for “completely” repealing Obamacare, eliminating the individual mandate, and allowing individuals to use health savings accounts (HSAs).

“Contributions into HSAs should be tax-free and should be allowed to accumulate,” states the Trump policy paper. “These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.”

HSAs are a solution that former Republican presidential candidate and Trump surrogate Ben Carson, MD, has advocated for several years. Carson, who is reportedly being considered to head the Department of Health and Human Services or serve as Surgeon General in the new administration, contends that HSAs for everybody—including indigents—would “inject personal responsibility” into healthcare.

According to Carson, HSAs are a simple and effective alternative to the ACA that help to put healthcare back under the control of individuals—where he believes it belongs. In addition, he has argued that every child that is born in America should receive an HSA.

Carson told Yahoo Global News Anchor Katie Couric in an interview on Wednesday that Trump’s plan for what replaces Obamacare “has to be something that’s very attractive, rather than something that you have to force people into.”

When it comes to the ACA’s individual mandate, the Trump healthcare policy paper emphatically states that “no person should be required to buy insurance unless he or she wants to.”

“Dismantling Obamacare can be done in a very compassionate way,” Carson told Couric. At the same time, he concluded that it’s not enough to repeal the ACA, which must be replaced with a “viable alternative that puts care back in the hands of patients.”

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