Who cares about Donald Trump's concepts of a healthcare plan? Another presidential debate, and Trump floundered again when asked about healthcare/ Trump said he had concepts of a plan without further explaining, but his answer was far better than what he said in 2020. Back then, Trump said he had plans to release a new healthcare plan shortly, but it never came. This time, he announced an openness to keeping the Affordable Care Act (Obamacare) in place and making it as good as possible while acknowledging its flaws.
This is the way for Republicans.
Republicans deserve credit for gutting some of the worst aspects of the Affordable Care Act. The Tax Cuts and Jobs Act of 2017 that Trump signed eliminated the individual mandate for health insurance, so there’s no longer a penalty from the federal government for poor people who lack health insurance. It was a regressive fee on people who already struggle financially. Some Republicans flubbed the argument against the individual mandate, like John McCain, who said that some people don’t want health insurance. That’s bullshit. Everyone should have health insurance, and the only reason any same person wouldn’t want it is because they can’t afford it.
Various states still have individual mandates where people pay fines for the pleasure of not having health insurance—and these people not only lack protection against financial ruin in the event of sickness or injury, but they must pay the government hundreds or sometimes thousands because they lack that financial protection.
Trump also killed the Affordable Care Act's Cadillac and medical device taxes, like the individual mandate. The Cadillac tax was a 40 percent tax on great employer-sponsored health insurance plans meant to disincentivize the overuse of the healthcare system. God forbid parents take their kids to the doctor's office when sick. The Cadillac tax was unpopular with union workers and a holdup that made some Democratic politicians initially hesitant to support the ACA. Meanwhile, the medical device tax imposed a 2.3 percent tax on tools used in healthcare, like X-ray machines, hospital beds, and MRI machines. It would’ve upped healthcare costs.
Regardless of how one feels about the American healthcare system, the political will to radically change it is nonexistent. Republicans tried unsuccessfully to repeal the ACA in 2017, with three of the 52 Republican Senators defecting; the chief concern was that repealing the ACA would result in 26 million fewer Americans having health insurance by 2026. The GOP attempt was politically unpopular—and a big reason for the blue wave in the 2018 midterm elections. It’s likely even more unpopular now. Conversely, Democrats failed to get a public option even when they had 60 Democrats in the United States Senate — and only a fraction of elected Democrats support single-payer healthcare, killing private insurance. The Kamala Harris 2024 presidential campaign acknowledges this reality. She ran on Medicare-for-All in 2019, then supported a Medicare-like public option. After that, she became Joe Biden's running mate, who supported a public option during his 2020 campaign but magically stopped talking about it after winning the election. The Harris 2024 campaign, to its credit, makes no such promises. That leaves us with the flawed status quo no matter who wins in November, but it’s a status quo where over 90 percent of the country has, at least, some health insurance.
Instead of promising to force health insurance companies and taxpayers to cover expensive in-vitro fertilization, which would make health insurance less affordable, Trump should promise to embrace pragmatic measures to stabilize healthcare costs and increase accessibility to health insurance. Some ways to do it include: mandating greater price transparency, letting Medicare negotiate more prescription drug prices, working with states on prescription drug importation plans, expanding catastrophic coverage eligibility for healthy people in their 30s, and streamlining regulations that cause administrative waste in the healthcare system. I support a catastrophic public option that covers preventative care and protects people from financial ruin while offering no coverage for elective abortion, in-vitro fertilization, euthanasia, and so-called gender-affirming care. I implore Republican and Democratic lawmakers to consider the proposal, along with these other proposed reforms. However, I can’t imagine it becoming law no matter who wins the presidency, even though JD Vance supports universal catastrophic coverage.