Trump Sketches Plan to Replace ACA, Speed Drugs to Market


February 28, 2017

Addressing a joint session of Congress, President Donald Trump tonight laid     out a now-familiar game plan for repealing and replacing the Affordable     Care Act (ACA) and asked Republicans and Democrats to join forces and "get     the job done, and get it done right."

So far, a unified Republican plan for replace-and-repeal has yet to     materialize. Several bills have surfaced in the Senate, House Speaker Paul     Ryan (R-WI) has promised to introduce a measure next month, and the Trump     administration also has said it would weigh in with a proposal.

Trump tonight also made a pointed pitch for reducing government regulation,     particularly in the US Food and Drug Administration (FDA) for the sake of     developing new drugs. Noting that it was Rare Disease Day, he called     attention to a 21-year-old woman named Megan Crowley in the Capitol gallery     who was diagnosed with Pompe disease as an infant and not expected to live     past age 5. The congenital disorder is also called glycogen storage     disease type II. Crowley's father was instrumental in developing a drug that     allowed her to grow up to attend the University of Notre Dame.

"Megan's story is about the unbounded power of a father's love for a     daughter," Trump said. "But our slow and burdensome approval process at the [FDA] keeps too many advances, like the one that saved Megan's life, from     reaching those in need. If we slash the restraints, not just at the FDA,     but across our government, then we will be blessed with far more miracles     just like Megan."

Trump, who has not yet nominated a commissioner for the FDA, has claimed     that as much as 75% of all government regulation could be erased without     harm to society, a claim some have called unrealistic.

Guiding Principles for Repeal-and-Replace

Trump and his Republican allies in Congress have been discussing elements     of a plan to repeal and replace the ACA for weeks. Tonight, the president     pulled many of them together under the rubric of guiding principles:

  • A replacement plan should first ensure that people with pre-existing         conditions have access to coverage, and that "we have a stable         transition for Americans currently enrolled in the health care         exchanges."

  • The federal government should help Americans buy the coverage they want         — "not the plan forced on them by our government" — with the help of         tax credits and expanded health savings accounts.

  • More control of Medicaid should be shifted from the federal government to the         states. "We should give our state governors the         resources and flexibility they need with Medicaid to make sure no one         is left out," Trump said.

  • Trump appeared to refer to medical liability reform — now in the works         in Congress — when he spoke of "legal reforms that protect patients and         doctors from unnecessary costs." In the same breath, he called for         efforts to "bring down the artificially high price of drugs."

  • Allowing the sale of health insurance across state lines, he said, will         create more competition that will lower costs and improve care.

Trump's criticism of the ACA was just as familiar as his talking points     about replacing the law. He said premiums for health plans on the ACA     exchanges have increased by double and triple digits. However, the Kaiser     Family Foundation reports that most people in these plans receive premium     tax credits, which have increased as well, shielding many individuals from     the premium hikes. Trump also noted that one third of American counties     have only one insurer due to a market exodus.

"Mandating every American to buy government-approved health insurance,"     Trump said, "was never the right solution for our country."

Democratic Response: Keeping the Commitment

In the official Democratic response to Trump's speech, former Kentucky     Governor Steve Beshear acknowledged that the ACA needed repair.

"But so far, every Republican idea to replace the [ACA] would reduce the     number of Americans covered, despite your promises to the contrary,"     Beshear said, addressing Trump. "These ideas promise access to care, but     deny the importance of making care affordable and effective. They would     charge families more for fewer benefits and put the insurance companies     back in control."

Before the ACA's passage, Beshear said, his fellow Kentuckians who lacked     insurance coverage "woke up every morning and went to work, just hoping and     praying they wouldn't get sick because they knew that they were just one     bad diagnosis away from bankruptcy."

"In 2010, this country made a commitment, that every American deserved     healthcare they could afford and rely on, and we Democrats are going to do     everything in our power to keep President Trump and the Republican Congress     from reneging on that commitment."

Follow Robert Lowes on Twitter        @LowesRobert


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