Lynne Stevens
Is health care important to your family?
We are fortunate to have two sliding scale payment health care providers here in Graham County. In 2021, the Democratic Congress capped Affordable Care Act premiums at roughly 8.5 percent of income to help with affordability issues. Although far from perfect, the act provides significant subsidies to millions of families.
However, without Congressional approval in 2025, the subsidies will expire. The Inflation Reduction Act and the American Rescue Plan helped millions afford health care when Americans needed it most during COVID. If the GOP wins the Senate and refuses to extend the subsidies, it will cause hardship to millions of families.
So what does the former President have in mind for medical care? To be honest, it is hard to tell – as his positions have changed so many times, and it has been hard to get anything consistent and specific out of him.
In January 2023 it was “repeal and replace” – with no plan to replace and still no identifiable plan to replace. USA Today and NPR made requests for detail of the replace part which never came.
The only response by the Trump Campaign was he will make health care affordable and much better. Again, no details.
In Detroit on May 19, he said he would “terminate” the Affordable Care Act and called it a disaster. In another change, he stated he was not running to terminate the Affordable Care Act – but make it bigger, better, and far less expensive.
Other than a hefty cut in benefits, premium increases or some form of price controls, no one seems to know how that can be accomplished. We have only his history on the subject to try and figure it out.
While he was President, Trump ended targeted taxes to companies participating in the Affordable Care Act earmarked to help subsidize low-income folks afford premiums. Trump stated that starving the program of funds from those taxes would cause the Affordable Care Act to be “dead and gone” (JAMA Health Forum). The intended result backfired and resulted in greater low-income subsidies; which went from corporate-tax funded to taxpayer funded.
Project 2025 is the proposed transition plan if Trump wins the election. It outlines a block-grant program to states for Medicaid. In other words, the states would get one annual amount of money to pay for Medicaid – no matter the actual costs. States will be required to pay short falls (ccf.georgetown.edu). Lifetime caps – currently not permitted – could be back in play together with more stringent eligibility requirements, asset tests and more work requirements.
The Georgetown University McCourt School of Public Policy has understandable explanations of how those on Medicaid could be affected. It is worth a look.
Looking at history, we can reasonably – predict based on decisions of the past administration – that there will be many attempts to cut benefits, cut subsidies and weaken coverage under the Affordable Care Act and Medicaid.
What does the GOP have in mind for Medicare and Social Security – and are there breadcrumbs for us to follow for answers?
Lynne Stevens writes a bi-weekly column for The Graham Star. She can be reached via email, geminga@mailfence.com.