This isn’t the bill he campaigned on.
During his campaign for president, Donald Trump set himself apart from the other Republicans vying for the nomination by claiming his election would mean a new health care system — one with lower costs, better care, and universal coverage. It all sounded pretty good, actually.
But now that he’s in office, his tune has changed.
Trump has endorsed both the House and Senate versions of health care reform, even though they’re exactly the types of plans he claimed he was against: ones that gut Medicaid, reduce the number of people with health insurance, and do nothing to control costs.
On Monday, the nonpartisan Congressional Budget Office confirmed the Senate’s bill is as bad as originally thought, leaving 22 million additional people uninsured.
So what gives? Was Trump lying during the campaign (something he has more than a bit of history with), or does he simply not know what he’s endorsing? Whatever these new health care bills are, they’re not what he promised.
Here are 10 of the biggest differences between what Trump promised and what he helped deliver.
1. Everybody will have health insurance and access to care.
“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” —Trump in a Jan. 15, 2017, Washington Post interview
While Trump has claimed to support making sure everybody has access to health care numerous times over the past two decades (In 2015, he even proposed a government-funded system on “60 Minutes“), this bill will cause 22 million more people to lose access to care.
2. Health insurance will cover more, cost less, and have lower deductibles.
“We will create quality, reliable, affordable health care in a free market where parents can make the health care decisions that they really want to make for their families. It will be a much better health care at a much less expensive cost.” — Trump at a Nov. 1, 2016, rally in Valley Forge, Pennsylvania
“Care will get better and costs will go down” is a great bumper-sticker-ready slogan, but it’s not realistic.
The ACA slowed the pace of annual premium increases to the lowest they’ve been in decades. The truth is that both House and Senate versions of the new health care bill will lead to skyrocketing premiums and won’t do much in terms of lowering deductibles either. As far as the “great health care” aspect of this goes, eliminating essential health benefits will lower the overall quality of health insurance plans.
3. People with pre-existing conditions won’t lose coverage.
While both House and Senate bills say insurance companies can’t deny someone coverage on the basis of pre-existing conditions, insurance companies will once again be allowed to charge those people a significantly higher premium, pricing them out of the market, which will have the same effect.
4. There will be no cuts to Medicaid.
The Senate’s bill guts the program. Full stop. If passed, it’d be the largest cut in the program’s history.
5. Health care reform would “fix our broken mental health system.”
“We must expand treatment programs, and reform the laws to make it easier to take preventive action to save innocent lives. Most people with mental health problems are not violent, but just need help, and these reforms will help everyone.” — Trump’s campaign website
The proposed cuts to Medicaid and allowing states to opt out of essential health benefits (such as coverage for mental health services) will actively make things worse.
6. Under the new bill, Trump promised that “you will be able to choose your own doctor.”
“We will repeal and replace disastrous Obamacare. You will be able to choose your own doctor again.” — Trump’s July 21, 2016, acceptance speech at the Republican National Convention in Cleveland, Ohio
This promise seems mostly to be a jab at President Barack Obama’s claim that the Affordable Care Act would let people keep their existing doctor and insurance plans if they wanted to — something the legislation couldn’t back up. It’s been one of Trump’s go-to lines over the years, tweeting about it 18 times and counting.
But there’s one major problem with Trump’s promise to restore the ability to “choose your own doctor again”: It doesn’t actually address this issue. Losing your insurance due to premium increases or an employer’s decision to go with a different carrier is an issue that long pre-dates the ACA, as is the fact that the insurance accepted by doctors can also change at a moment’s notice. The ACA didn’t fix that, and neither do the House or Senate reform bills.
7. “Require price transparency from all health care providers.”
“Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.” — Trump’s campaign website
One thing that the ACA didn’t do nearly enough is work to control health provider costs. And neither the House or Senate health care proposals do either. This isn’t addressed.
8. It will be legal to purchase prescription drugs from other countries.
“Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. … Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers. The reforms outlined above will lower healthcare costs for all Americans.” — Trump’s campaign website
On the surface, being able to reimport drugs from Canada and other countries sounds like a pretty great cost-cutting measure for consumers. There’s definitely a debate over whether this would actually lower costs, but the truth is that this isn’t addressed in either the House or Senate health care bills.
9. “People aren’t going to be dying on the sidewalks and in the street.”
“The people aren’t going to be dying on the sidewalks and in the street, not if I’m president. So we’ll work out a deal. We’ll get them into the hospital. We’ll get them in to see doctors. … But I’m not going to allow people to die on the sidewalks in the street.” — Feb. 29, 2016, episode of “Hannity“
Location aside and with 22 million more people standing to lose health care, people will die under this bill. Making it harder to pay for health care means it will be harder for people to actually get that much needed medicine, health exam, or admittance into a hospital or treatment program that could save their life.
10. “This is a repeal and replacement of Obamacare.”
Both the House and Senate bills amend portions of the ACA, but they don’t actually repeal the law.
Hillary Clinton ran on amending the ACA to address a number of specific issues related to the rising cost of care, the opioid crisis, premium increases, a lack of consumer choice, and more. During the campaign, Trump spoke mainly in vague platitudes about what he’d like his health care plan to be (“great,” “wonderful,” and so on) with very sparse specifics. One of those specifics, however, was to repeal and replace Obamacare.
This bill doesn’t do that. Instead, it chips away at an existing system without offering solutions for the overwhelming majority of the country.
It’s not too late to do something about it.
No matter who you voted for, no matter what your political views are, this bill isn’t what voters signed up for. The Senate hopes to bring the bill up for a vote sometime this week. The best thing you can do between now and then is to give your senators a call and let them know that you want them to vote no.