Here’s The Good, The Bad, And The Ugly Of Trump’s Health Plan

On Thursday, the White House released its self-described “Great Health Care Plan” (emphasis in the original). The plan — all 359 words of it (yes, I counted) — contains some good policies and some not-so-good ones. 

Most notably, however, it eschews any reference to the enhanced Covid subsidies that the administration was reportedly going to embrace just before Thanksgiving. That in itself should relieve conservatives, but it doesn’t mean the plan’s other components don’t deserve scrutiny of their policy merits, or lack thereof.

The Good

In theory, sending money to patients rather than insurance companies will give the American people greater control over their health care choices, while promoting competition. However, as previously noted, such a move should not include any supposed “flexibility” regarding taxpayer funding of abortion, a policy that bipartisan majorities have supported for going on half a century.

Likewise, proposals to allow more pharmaceuticals to be sold over-the-counter hold some appeal. Expanding the OTC marketplace could increase competition, while also lowering health care costs by eliminating additional trips to the doctor to obtain prescriptions. By contrast, Obamacare included language (since repealed) requiring people to obtain a prescription to have OTC medicines reimbursed from a Flexible Spending Arrangement or Health Savings Account, which resulted in a rush of unnecessary appointments where patients asked for “prescriptions” for things like NyQuil (seriously).

The Bad

I wouldn’t call these policies “bad,” so much as “meh.” Proposals to increase transparency — requiring insurers to explain their plans in plain English, publish their rates of treatment denials, and publicize their percentage of administrative overhead, and mandating providers to publish their prices — should help at the margins. But as I previously noted, it shouldn’t take an act of Congress, or myriad federal regulations implementing such an act, to inform people about price and quality information readily available in literally every other type of market. Part of me celebrates a reform that can help people become more informed consumers and patients, while the other part of me laments that it will necessitate more government red tape to do so.

The proposal to fund the cost-sharing reduction program falls into a similarly ambivalent category. (This issue gets very wonky very quickly; I have a technical explainer as part of my summary of last month’s House bill that addressed this issue.) On the one hand, this proposal would lower premiums for Exchange plans, particularly for people (like me) who don’t qualify for subsidies. On the other hand, this policy would implement Obamacare, and it would also make direct payments to insurers, which directly contradicts the plan’s other proposal to “stop sending big insurance companies billions in extra taxpayer-funded subsidy payments.” 

The Ugly

As I wrote previously, the worst of the White House proposals concerns policies to codify the president’s Most Favored Nation deals, “to get Americans the same low prices for prescription drugs that people in other countries pay.” While Americans do pay more than many overseas nations for pharmaceuticals, we should by no means want to import the rationing systems that many countries with socialized medicine use to (artificially) create those supposedly “low prices.”

Moreover, I have also noted that codifying these proposals would harm those most vulnerable among us — namely, individuals with disabilities, whose lives are deemed “not worth it” in several countries’ health care rationing systems. The National Council on Disability has argued that these types of price controls violate the Americans with Disabilities Act, making them not just bad policy but potentially illegal. 

American patients deserve lower health care costs, which several policies in the president’s health care plan would achieve. They don’t deserve arbitrary discrimination against the most vulnerable, which could result from codifying the White House’s price control plan.