Donald Trump Hates Obamacare – So I Asked Him How He’d Replace It

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Donald Trump is leading in numerous major polls of GOP presidential candidates. And the first Republican presidential debate is looming next week.

Whether or not you think Trump’s a spectacle, I think it’s past time to start taking him seriously. Even when it sounds like he’s trying to be funny.

Take his comments on health care this week. Speaking with CNN, Trump said that the Affordable Care Act has “gotta go” and that he would repeal the law and replace it with “something terrific.”  (Trump added that he’d “work out some sort of a really smart deal with hospitals across the country,” to provide care for poor Americans.)

It’s typical Trump. Quotable. Bombastic.

But it doesn’t make any sense — especially when you look at Trump’s complete comments on health care.

I know, because I asked him about it.

After Trump announced he was running for president (again), I pestered his campaign to resolve a few inconsistencies on his health care plan. Why did Trump once support universal health coverage? How did his constant bashing of Obamacare jibe with reality? And via a Trump spokesperson, I got responses back.

Some answers are revealing. For instance, Trump isn’t just a “birther” — he’s an unemployment truther, too. (He believes that the national unemployment rate is over 18%, more than triple what the government has reported).

And in classic Trump style, many answers are aggressive and confrontational. But they’re far from realistic about how health care works.

Below is a lightly edited transcript, with my questions in bold. At the bottom of this story, I’ve offered a few thoughts on the Trump campaign’s comments.

Q: About 15 years ago, Mr. Trump publicly pledged his support for universal health care, and said that he’s “liberal” when it comes to expanding coverage. Is that still the case?

A: Donald Trump has never supported socialized medicine. In ‘The America We Deserve,’ Mr. Trump called for health market reforms that would be “affordable, well-administrated, and provide freedom of choice.” He supported a universal “market-based” plan that would offer a range of choices.

Mr. Trump does not believe socialized medicine is the solution to expanding coverage. The federal government is clearly incapable of managing [one-fifth] of the total economy. The ObamaCare federal and state exchange websites, which cost over $5 billion, could not even operate properly.

The only solution is a free market orientated [sic.] plan that provides consumer choice, keeps plans portable and affordable and returns authority to the states. We also must break the insurance company monopolies and allow individuals to purchase health insurance across state lines.

Q: Mr. Trump has spoken out about the Affordable Care Act, arguing that the law would “take down our economy,” especially once the law’s provisions kicked in in 2014.

Given that the U.S. unemployment rate has dropped below 6% and that the ACA’s projected costs have only fallen since it was passed, does he still believe that?

A: President Obama promised that ObamaCare would not add “one dime to the deficit” in 2009. ObamaCare is now projected to cost the federal government at least $1.2 trillion between 2016 and 2025. Our national debt is fast approaching $20 trillion and ObamaCare is clearly a contributing factor to the record rate that debt is rising.

Mr. Trump believes that the real unemployment rate is over 18%, not the reported 5.5%. This while ObamaCare’s employer mandate has been delayed until 2016. If the mandate is ever fully implemented, even more Americans will be unemployed.

ObamaCare continues to hurt the economy. Our first quarter GDP was -0.7%. [DD note: On Thursday, the Commerce Department revised first quarter GDP to a positive 0.6%.] There is a causal connection as ObamaCare stops companies from expanding and also makes more workers part time.

Over 70% of our GDP comes from personal consumption. The ObamaCare mandate reduces disposable income for all Americans and therefore will continue to reduce our GDP. Plus, the dramatic increase in premiums have steadily continued in 2014 and 2015. Many insurers are calling for double digit increases in 2016. ObamaCare is clearly unsalvageable and unmanageable.

Q: Given his historic commitment to universal health care, how does Mr. Trump feel about the U.S. uninsured rate hitting historic lows, likely because of the Affordable Care Act?

A: Mr. Trump supports a universal “market-based” plan that would offer a range of choices.

At least 70% of ObamaCare enrollees were previously insured. They did not gain coverage and in many cases were dropped from their plans. ObamaCare’s premiums continue to rise and the rising cost curve of healthcare is also unsustainable. Further, the vast majority of ObamaCare enrollees are joining Medicaid. Employer group coverage continues to drop. This is clearly not the solution to solving healthcare.

Let’s also remember that health insurance is not health care. There [are] a number of ways people are able to take care of their medical and health issues without insurance.

Q: If Congress did away with the Affordable Care Act, what health reform plan would Mr. Trump propose in its place?

A: Mr. Trump will be proposing a health plan that will return authority to the states and operate under free market principles. Mr. Trump’s plan will provide choice to the buyer, provide individual tax relief for health insurance and keep plans portable and affordable. The plan will break the health insurance company monopolies and allow individuals to buy across state lines.

Let’s unpack Trump’s comments, and fact-check them along the way.

1. Trump misrepresents the government’s role in health care.

The problem with arguing that the U.S. has a government-run health care system is that the government doesn’t actually run health care in the United States.

Yes, the federal government plays an enormous role. More than 120 million people get health coverage through Medicare and Medicaid. And 10,000 people are now enrolling in Medicare every day.

But you know who spends even more than the feds on health care — and has its own problems with efficiency? The private sector.

Trump also criticizes the Affordable Care Act insurance exchanges, but that’s a dated political attack that could backfire. Sure, the exchanges famously sputtered to launch in a historic, failed debut — but the government also got them working in a historic recovery effort, too. Drawing on the latest data about Americans’ positive experiences with the marketplaces, you could make a strong case that the exchanges are actually a government triumph.

2. Trump confuses the role of Obamacare and the deficit

Trump says that getting rid of the Affordable Care Act would help America’s economy.

But no more ACA would mean no more health coverage for tens of millions of people, which would harm economic growth.

The non-partisan Congressional Budget Office in June found that repealing the ACA would actually increase the deficit by as much as $353 billion over the next 10 years.

Also See: Republicans Called Obamacare A “Job-Killer.” Were They Wrong?

3. Trump puts too much faith in selling insurance across state lines.

Trump pins a lot of hope on a classic free-market idea: That deregulating the health insurance industry would increase competition, and Americans would benefit by shopping around from state to state.

But many experts say it doesn’t actually work like that. At least, not in health care.

In reality, allowing insurers to sell across state lines might accomplish … almost nothing, researchers from Georgetown’s Center on Health Insurance Reforms wrote in 2012.

That’s partly because proposals to deregulate who can buy a health insurance product ”do not address the true drivers of health insurance costs nor do they adequately take into account the complexity of how insurance products are sold and regulated,” the researchers point out.

And in a worst-case scenario, the lack of regulation would lead to some health insurers being able to cherry pick customers, squeezing out the most vulnerable patients — the ones that the Affordable Care Act is most likely to help, watchdog groups predict.

The National Association of Insurance Commissioners — which helps set standards and regulations across the insurance industry — has warned against exactly this.

“Some have suggested that allowing interstate sales of health insurance policies will make coverage more affordable and available,” NAIC wrote several years ago.

“In reality, interstate sales of insurance will allow insurers to choose their regulator, the very dynamic that led to the financial collapse that has left millions of Americans without jobs. It would also make insurance less available, make insurers less accountable, and prevent regulators from assisting consumers in their states.”

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Source: Forbes