Tonight's address to Congress will be the first of the Trump presidency, and it will be heavy on policy matters - especially as it relates to what's coming next following the imminent repeal of ObamaCare. To help lay the groundwork for that, Trump met yesterday with many of the insurers who've been losing their shirts on ObamaCare exchanges and asked them to get on board and help ensure a smooth transition:
Trump told the insurers that his changes would include expanded healthcare savings accounts, which are tax-free savings accounts typically used with high-deductible insurance plans, and the sale of health plans across state lines. He also said that he wanted states to have more flexibility but did not provide details.
Trump previously discussed these ideas on the campaign trail. It is unclear how they would be implemented, or what changes he might make to Medicaid expansion, another key component of the Obamacare law.
Trump told insurers, including UnitedHealth Group Inc, Anthem Inc. and Aetna Inc., that he was directing Health and Human Services Secretary Tom Price to work with them "to ensure a smooth transition to the new plan."
The administration recently gave the insurers one of their biggest requests and proposed a rule that would tighten eligibility verification for subsidized plans and allow them to seek unpaid premiums.
Trump is also seeking support from the nation's governors for changes. The Obamacare law, which extended health insurance to 20 million Americans, has been popular in many states, even those controlled by Republicans. But it has also been criticized for its steep premium increases.
Reuters characterization of ObamaCare as "popular in many states" is awfully misleading
That Reuters characterization of ObamaCare as "popular in many states" is awfully misleading. When someone receives a benefit they didn't have before, and it's subsidized by someone else, of course they like it. The people who are seeing their premiums soar, or are seeing their taxes go up because they don't understand who pays for the subsidies or for expanded Medicaid, aren't happy but don't necessarily understand the connection between the problem and ObamaCare.
That's because the media don't tell them about it, but I guess we've discussed that to death.
We'll have detailed coverage of Trump's speech, along with video of the whole thing. And no matter where you read coverage - even if it's from us - I encourage you to watch the video for yourself, in its entirety. That way you're not relying on someone who has an agenda one way or the other to pull a line or a phrase from the speech and try to tell you it's all you need to know.
Trump's appeal to the insurers is crucial, of course, because the biggest challenge of replacing ObamaCare is how to transition people from newly created, subsidized plans that are no longer going to exist. At the same time, you have to recognize that insurers are already losing money on these policies - and many have bailed from the exchanges for that reason - so the solution can't further bleed the insurers dry. It's a tricky puzzle to solve, but it would be impossible if the insurers weren't willing to work with the administration and Congress in implementing the solution.
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Also, keep in mind as you watch tonight that this is Trump's proposal to Congress, and not necessarily the plan Congress will pass. I suspect Trump and congressional leaders are largely on the same page on the things he'll say tomorrow night, otherwise he'd be creating a gigantic clusterfark by saying them in such a high-profile manner. But it's still not official until it's in a bill on his desk and he signs it.
My guess is that Republicans would like to get the replacement for ObamaCare worked out as quickly as possible, not only as a policy imperative but also because the nation has spent the past seven years grappling with this issue and it's time to get it settled and move on from it. We have debt to deal with, energy policy to improve, a tax code to rewrite and lots of other things that need to be done. We can't get bogged down by ObamaCare for the rest of our lives, so the time to get rid of it and replace it with something better is now.
Hopefully Trump is very effective at laying the groundwork for that tomorrow night.
