Distinguished Professor Emeritus School Of Public Affairs & Administration
For analytic purposes, the term sabotage, should not be used lightly. Presidents upon taking office typically have priorities that trigger executive actions strengthening some programs while weakening others. The losing programs often face resource reductions, pressure to deemphasize certain goals, directives to alter their administrative approaches, and other measures that can undermine their effectiveness. In doing so, a president often pays lip service to the program, claiming it has been modernized or otherwise improved. In contrast, Websters defines sabotage as efforts to foster destruction and obstruction and to cause the failure of something. In the context of the administrative presidency, it reflects a commitment to program emasculation and termination through executive action. As such, it sharply departs from the constitutional requirement that the president take care that the laws be faithfully executed.
The Trump administrations efforts to sabotage the ACA and their consequences receive detailed attention in a recently released Brookings book, Trump, the Administrative Presidency, and Federalism. For present purposes, I highlight six major sabotage initiatives which emerged in the wake of congressional failure to repeal and replace the ACA.
Insurance Companies Love A Lack Of Competition
You know who loves a lack of competition? Those insurance companies, who are making a fortune because they control the politicians.Theyve paid for them with their contributions, and its a good investment from their perspectives. For our country, not so much. They give money to almost all the politicians.
Senate Gop Blocks Dem Effort To Cap Insulin At $35 Per Month As ‘vote
Good politics involves consistent, simple messages. Opponents of the Trump administration believe they have found one with health care: sabotage. When new numbers showed a small uptick in the number of uninsured from 2017 to 2018 , Democratic presidential candidates and House Speaker Nancy Pelosi all had statements including that accusation against the Trump administration.
But they are wrong. After congressional efforts to replace ObamaCare failed, President Trump signed an executive order to expand Americans health care options and promote market competition. This order led to bold actions to improve the nations health sector and help middle-class families. In particular, the administration expanded access to more affordable coverage, returned regulatory oversight from Washington to the states and increased options for employers to offer health insurance to their workers. Many of these changes essentially reversed Obama administration restrictions that were intended to force everyone into one-size-fits-all plans.
For example, in a rule that was pushed through right before President Barack Obama left office, his administration severely restricted short-term plans. These plans are not subject to ObamaCares costly mandates, so they are more affordable for millions of people. Last summer, the Trump administration reversed the Obama administrations restrictions, allowing millions of Americans the ability to purchase quality insurance that better meets their needs.
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Replace Obamacare With Health Savings Accounts
TRUMP: Well, Im OK with the savings accounts. I think its a good idea its a very down-the-middle idea. It works. Its something thats proven.The one thing we have to do is repeal and replace ObamaCare. It is a disaster. Peoples premiums are going up 35 percent, 45 percent, 55 percent. Their deductibles are so high nobodys ever going to get to use it.So ObamaCare is turning out to be a bigger disaster than anybody thought.
Q: So if you agree with these health savings accounts idea, do you also agree with Ben Carson when he says Medicare probably wont be necessary?
TRUMP: Well, its possible. Youre going to have to look at that, but Ill tell you what, the health savings accounts, Ive been talking about it also. I think its a very good idea.
Using Her Official Twitter Account Melania Trump Previously Gave Us An Insight Into What The Trump Administration Planned On Doing To Combat The Problem
She said this: I am deeply concerned about the growing epidemic of e-cigarette use in our children. We need to do all we can to protect the public from tobacco-related disease and death, and prevent e-cigarettes from becoming an on-ramp to nicotine addiction for a generation of youth.This can only mean one thing, right?
Of course, Donald Trump had to back his wife up! But the comments he made left us more concerned than anything
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Kill Obamacare Before It Becomes A Trillion
Obamacare is a heat-seeking missile that will destroy jobs & small businesses it will explode health-care costs and it will lead to health care that is far less innovative than it is today. Every argument that youd make against socialism you can makeagainst socialized health care, and any candidate who isnt 100% committed to scrapping Obamacare is not someone America should elect president. Repealing Obamacare may be one of the most important and consequential actions our next president takes.
A Team Of Doctors And A Luxury Suite
The president was also fortunate to have the high-tech facilities of the Walter Reed hospital so close by. People living in rural parts of the US may have to travel vast distances to get medical treatment.
A study from the University of North Carolina showed that 120 rural hospitals have closed in the past decade.
“Rural places have far fewer physicians to treat the virus , and smaller hospitals with less specialised services staff, and more uninsured people ,” says David J Peters, a professor in rural sociology at Iowa State University.
“The ability of using telemedicine to address this gap is limited, as nearly 55% of rural households do not have broadband internet access . Rural places are also vulnerable because they lack access to the interstate system, making transportation of patients, health providers, and supplies difficult and time consuming.”
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Vice President Mike Pence
Pence on healthcare
- The Trump campaign released a statement on November 14, 2016, detailing what Pence discussed at the Republican Governors Association Annual Conference. At the event, Pence “reiterated…Trumps strong commitment to repeal and replace Obamacare and block grant Medicaid funding to state governments to encourage innovation that better delivers healthcare to eligible residents.”
Pence on the AHCA
- On June 3, 2017, Pence urged members of Congress to pass the American Health Care Act of 2017 during a political rally in Iowa. He said, “First and foremost, this summer, this Congress must come together and heed the president’s leadership, and we must repeal and replace Obamacare. … Once we repeal and replace Obamacare, we’re going to roll our sleeves up, and working with these great leaders in Congress, we’re going to pass one of the largest tax cuts in American history.”
- On May 4, 2017, after the House passed the AHCA, Pence said, “It was March, 2010, seven years ago, Democrats passed a government takeover of healthcare. And at that time, Republicans in Congress promised the American people that law would not stand. Today, thanks to the perseverance, the determination, and the leadership of President Donald Trump, and all the support of those gathered here, weve taken a historic first step to repeal and replace Obamacare and finally give the American people the kind of healthcare they deserve.”
Pence on the ACA
How Does It Compare To Biden’s Healthcare Plan
If Biden wins, there will be a different, and seemingly bolder set of priorities for reshaping the ACA.
The possibility of a public option is one of the biggest differences between his plan and Trump’s.
The Biden campaign also says it will eliminate the cap on ACA insurance subsidies, so that people making more than 400% of the federal poverty level qualify for tax credits.
“You’re going to see a big push in trying to make it more affordable,” Emanuel said.
Another campaign promise from the Biden team: lowering the cap on how much coverage in the ACA marketplace can cost, from 9.86% of a person’s income to 8.5%.
Regardless of who wins the election, it’s going to take a lot longer than four more years for this healthcare law to mature.
Just look at how many times Social Security’s been reformed and tweaked, since it was enacted by President Roosevelt in 1935. Or the changes that have been brought to the Medicare and Medicaid systems, since they were signed into law by President Johnson in 1965.
President Obama’s Affordable Care Act has joined this cannon of sweeping reforms. As such, it will take decades to refine, through many more presidents, and many more sessions of Congress. Despite what you might’ve heard about “repeal” or “replace,” improving it will take more continuous, measured improvement of the system than any one President alone can provide.
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Oped: Ordered Healthcare Associations But No Follow
This has not happened.Trump issued an executive order on Oct. 12 to ask his Secretary of Labor to propose regulations to allow more employers to make use of association health plans. But the actual change has not actually been made yet, noted Timothy Jost, an expert onhealth law as an emeritus professor at Washington and Lee Universityso even if millions of people will eventually use these plans, they have, obviously, not been able to do so yet.
Trump added about people joining associations due to changes toObamaCare, Thats gonna be a big bill, you watch.
The move toward association health plans is not going to be a bill at all, let alone a big bill. This would be a change in regulation or guidance, not legislation, Jost noted.
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Expanding Medicare And Medicaid
Medicare and Medicaid are two different healthcare programs run by combined efforts of the federal and the state governments.
Medicare helps U.S. citizens ages 65 and older pay for medical expenses, while Medicaid assists low-income groups with healthcare expenses.
Trump has looked to make a number of administrative changes on Medicaid, giving states more authority, many of which have been criticized, said Levitt. The biggest one is work requirements for Medicaid enrollees.
The president supports lowering prescription drug costs but hasnt actively passed legislation on this yet, Levitt says.
Trump has broadened Medicare coverage of telehealth during the pandemic and expanded Medicare Advantage benefits.
Biden has said he aims to expand Medicare and Medicaid in an effort make healthcare coverage available to more than 97 percent of Americans.
Biden has said he would also offer premium tax credits for middle-class families.
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May 10 201: Cms Publishes Federal Rule Requiring Pharmaceutical Companies To List Drug Prices In Television Ads
On May 10, 2019, the Centers for Medicare & Medicaid Services , an agency within the Department of Health & Human Services , published a rule that required pharmaceutical companies to include the list price, also known as the wholesale acquisition cost, of certain prescription drugs in television advertisements. The requirement applied to medicine covered by Medicare or Medicaid and did not apply to drugs with a cost of $35 or less.
According to the summary of the final rule published in the Federal Register, the rule was intended to make Medicare and Medicaid administration more efficient by giving beneficiaries of the programs more information about the costs of drugs. CMS argued that the new rule would use public scrutiny to pressure manufacturers into lowering drug prices and would equip patients to make more informed healthcare decisions. Under the rule, television advertisements for prescription drugs were required to state the cost for a 30-day supply. The rule was to go into effect on July 9, 2019.
Thank You For Sharing
When it comes to health care, President Donald Trump has promised far more than he has delivered. But that doesnt mean his administration has had no impact on health issues including the operation of the Affordable Care Act, prescription drug prices and womens access to reproductive health services.
In a last-ditch effort to raise his approval rating on an issue on which he trails Democrat Joe Biden in most polls, Trump on Thursday unveiled his America First Healthcare Plan, which includes a number of promises with no details and pumps some minor achievements into what the administration calls monumental steps to improve the efficiency and quality of health care in the United States.
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Sen Braun Shares What He Thinks Is Real Reason For Dem Allegations Against Trump
bymichaelSeptember 22, 2022, 3:00 pm
According to Sen. Mike Braun, the announcement of a lawsuit being filed by New York Attorney General Letitia James against former President Donald Trump, his adult children, and his company for fraud is nothing more than an attempt by the Democratic Party to try and provide a distraction to pull eyes away from the mounting failures of the current administration ahead of the midterms in November.
A report from Newsmax said that the Indiana Republican made an appearance on National Report, where he said,The Democrats are going to do everything they can to distract what ought to be a platter of opportunity for us and bring it back to President Trump.
Braun insisted that the entire attempt appeared to be coordinated to help the chances of the Democratic Party in the November elections, as the senator tied it together with the Department of Justice investigation of the classified documents it accuses Trump of retaining illegally at his Mar-a-Lago home, the report continued.
Braun then spoke about President Joe Bidens speech that was made Wednesday at the United Nations General Assembly, remarking that he took issue with Bidens statement that whatever happens, were going to be the backstop.
Thats exactly whats wrong with many of these engagements, especially when you got the backyard interest of the E.U. that should be shouldering it, the Indiana senator said.
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Obama Makes First Public Appearance At White House Since 2017
President Trump will face off with former Vice President Joe Biden in the first presidential debate this week, where health care is bound to come up. While Democrats often attack Trump for a lack of a health-care plan, the truth is, his administration has significantly increased Americans choice of health coverage and improved access to care. In fact, Trump should be proud to campaign on his health-care record.
When Trump took office, Obamacare was wreaking havoc with the individual health-insurance market premiums and deductibles were escalating, and choices of coverage were dwindling. The Trump administration took steps to shore up these markets and premiums have held flat since 2018, with more insurers now offering plans.
At the same time, his administration also increased options for families and small businesses. A 2018 Trump rule expanded renewable and flexible plans not subject to Obamacares laundry list of expensive requirements. This rule expanded consumer protections for these more affordable plans by allowing people to keep them for up to three years instead of just three months.
The administration has reformed Medicare so that seniors can more easily receive care in the comfort of their own home over the phone or through video. Through the coronavirus public-health emergency, doctors can now be paid for providing virtual care, which can be safer and faster.
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Federal Policy On Healthcare 2017
| Federal policy on healthcare, 2017-2020 |
President Donald Trumps main healthcare policy initiative has been working to fulfill his campaign promise to repeal and replace the Patient Protection and Affordable Care Act , commonly known as Obamacare. He expressed his support for the House and Senate bills that proposed modifying parts of the ACA. The House passed its billthe American Health Care Act of 2017but members of the Senate have been unable to agree on a final replacement plan, leaving most of the provisions of the ACA in place. Republicans did take one step towards changing the ACA by eliminating the laws individual mandate, which took effect in January 2019.
In October 2017, the Trump administration took actions to modify the ACA. Trump issued an executive order directing members of his Cabinet to create rules that would allow small businesses to collectively buy health insurance through association health plans, expand short-term health coverage, and expand the use of Health Reimbursement Arrangements . The order did not make direct changes to existing health insurance rules instead, it directed agencies to consider new rules that would be subject to a notice and comment period.
This page outlines major events and policy positions of the Trump administration on healthcare. Click on the timeline below to learn more about each headline.
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May 11 : Trump Administration Unveils Drug Pricing Plan
WhiteHouse.gov
On May 11, 2018, President Donald Trump released his administrations plan to lower drug prices. While introducing the plan, Trump said, Under this administration, we are putting American patients first. Ive instructed Secretary Azar to begin moving forward on reforms that will bring soaring drug prices back down to earth. Our plan takes steps to derail the gravy train for special interests by ending Obamacares twisted incentives that actually encourage higher drug prices.
The plan included the following, according to a White House fact sheet:
Sen. Ron Wyden , the top Democrat on the Senate Finance Committee, criticized the plan, saying, Theyre breathing a sigh of relief in pharmaceutical board rooms across the country. Its still open season for drug companies to set astronomical prices that families cant afford.
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Obamacare Will Never Work Repeal It And Replace It
We have to get rid of the lines around the state, artificial lines, where we stop insurance companies fromcoming in and competing, because that gives the insurance companies essentially monopolies. We want competition.
You will have the finest health care plan there is. She wants to go to a single-payer plan, which would be a disaster, somewhat similar toCanada. And if you havent noticed the Canadians, when they need a big operation, when something happens, they come into the United States in many cases because their system is so slow. Its catastrophic in certain ways.
