President Donald Trump did not say anything about health care in his inaugural address, but one of his first official actions as president was to issue an executive order focused on the Affordable Care Act. While the executive order does not tell working people a whole lot about what he plans to do, it’s worth looking at a few things he did and didn’t say in his first official action on health care.
Trump says seeking "prompt repeal" of the Affordable Care Act is the official policy of his administration. Not a shocker. He doesn’t say anything in his order about what he would replace it with or the goals that will guide his administration in creating a replacement, even though he’s recently made promises in media interviews about providing "insurance for everybody" that is "much less expensive and much better" with "much lower deductibles."
Trump says he wants "a more free and open health care market." He doesn’t say what that means in reality, when health care providers like hospitals use dominant power in their local marketplaces to set high prices or health insurers with strong market power don’t pass along the benefits of price reductions to the people they insure or prescription drug corporations with monopoly rights set high prices without justification.
Trump says he wants to do away with ACA requirements that put a "regulatory burden" on a long list of health care stakeholders. He doesn’t say what he considers to be a "regulatory burden." Or that what a health insurance company sees as a "regulatory burden" could be the same thing that gives working people the right to buy a health plan without being discriminated against and without the tricks and traps insurance companies built into insurance policies before the ACA.
Trump says he’s concerned about the impact of the ACA on "individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products or medications." He doesn’t say anything explicit about what happens to the health benefits that working people get on the job, though Tom Price, his nominee to be secretary of health and human services, has a plan that would impose big new taxes on working people’s health benefits.
Yes, Trump has talked a lot about the ACA, but he hasn’t said nearly enough about what he intends to do or how he will do it. He says he has a plan that just needs some finishing touches. Working people are understandably worried about how his plan will impact them and their families. How could they not be with all of the talk among Republicans in Congress about repealing the ACA without actually having an immediate replacement and the news from Congress' budget experts that this could cost roughly 30 million people their health insurance. So, yes, it’s time for President Trump to say more.