Nov 4, 2020 - Health

Trump's lackluster health care legacy

Trump holding a health care bill up

Photo: Saul Loeb/AFP via Getty Images

If this is the end for the Trump administration, it will leave a legacy of failure on health care, and if he's re-elected, he'll have a lot of ground left to make up.

Why it matters: The administration failed to get almost anything it wanted — sometimes the setback was Congress, sometimes the courts, sometimes the administration itself.

  • The failed effort to repeal the Affordable Care Act in 2017 is at the top of that list.
  • The administration simply didn't enact any of its most aggressive proposals on drug pricing, including plans to change the way rebates are paid within the system, to reclassify some drugs within Medicare, and to tie Medicare's prices to other countries.
  • The biggest thing it did accomplish on drug prices — a regulation requiring list prices in TV ads — was blocked in court.
  • Medicaid work requirements, probably the most significant change the administration has pursued on its own, have also been blocked in court.

What's left: Rules requiring hospitals to disclose their prices could stick around, and President Trump did change the rules for short-term insurance plans that compete with ACA coverage, although a Biden administration could change those rules again.

  • And that leaves a legacy largely defined by the failure to contain the coronavirus.

Yes, but: There's still a big wild card outstanding, in the form of the Supreme Court case over the ACA.

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