Oct 11, 2019 - Politics & Policy

Trump's smoke-and-mirrors 2020 health care strategy

Illustration of President Donald Trump presenting a levitating red cross with his fingers crossed behind his back

Illustration: Sarah Grillo/Axios

President Trump may be telling voters everything that they want to hear when it comes to health care, but much of it isn't true.

Why it matters: Trump is claiming victories he hasn't achieved and making promises he's not prepared to live up to, all on an immensely personal subject that voters consistently rank as one of the most important issues of 2020.

Trump's most demonstrably false claim is that, as he put it in May, “we will always protect patients with pre-existing conditions."

  • The Trump administration is currently urging the courts to strike down the Affordable Care Act, including its protections for pre-existing conditions.
  • Trump and congressional Republicans' efforts to repeal and replace the Affordable Care Act in 2017 didn't include the same level of protection as the ACA does, nor have they ever proposed a plan that would.

Trump's claim that he has lowered drug prices for the first time in 51 years is murky at best. The timeframe is definitely wrong, as WaPo reports, though the recent realities of drug pricing are more nuanced.

  • Prices for generics are falling, which brings down the average cost of drugs overall. Prices for commonly used drugs, including generics, fell in 2018, according to a White House report.
  • But that average masks steady increases in the price of drugs that treat rarer diseases, which don't have generic competition.
  • Brand-name drugs' prices increased by only 0.3% in 2018, per IQVIA, although per-capita spending on specialty drugs increased by 5.8%.

On defense — attacking Democrats over "Medicare for All" — Trump is also making some dubious claims.

  • "Almost every major Democrat in Washington has backed a massive government healthcare takeover that would totally obliterate Medicare.... They want to raid Medicare to fund a thing called socialism," he said last week.
  • Sen. Bernie Sanders' "Medicare for All" bill would indeed replace traditional Medicare, but seniors' health care benefits would get more generous under that plan, as written — not less. However, critics of the plan say it would likely reduce seniors' access to care.
  • And though it's true that Sanders' bill would eliminate private health insurance, other plans would retain it as an option.

The other side: "Democrats, apparently unsatisfied with lying about healthcare once when they introduced Obamacare, have now introduced sweeping proposals, such as Medicare-for-All. These radical and dangerous policies would take away the insurance Americans know and trust while raising taxes and reducing choice," White House spokesman Judd Deere said.

Yes, but: There's still a lot of time left before 2020, particularly for Trump to do something major on drug prices.

  • The administration's proposal to tie Medicare's payments for some drugs to the prices that other countries pay is still in play, and both the White House and House Democrats have said they're hopeful that there's still a drug-pricing deal to be made.

Go deeper: Trump still doesn't have an alternative to "Medicare for All"

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