May 1, 2017
Deconstructing Trump's health care promises
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Carolyn Kaster / AP
President Trump made some pretty optimistic promises about the health care bill twice this weekend — at his rally in Pennsylvania and on Face the Nation. So it's worth examining what he said, and how likely it is that we'll have to re-examine his promises if the bill becomes law. (Just like we all had to re-examine Barack Obama's "if you like your health plan, you can keep it" when that didn't work out.)
- "We're going to get the premiums down, we're going to get the deductibles way down, we're going to take care of every single need you're going to want to have taken care of, but it's not going to cost that kind of money." — At Harrisburg, PA rally
- Reality check: Health insurance is a series of tradeoffs — you can have lower premiums or lower deductibles, but usually not both. And if they are both lower, it's usually because the plan covers fewer benefits. It's rare to have a cheaper plan that covers "every single need."
- "Pre-existing conditions are in the bill ... They say we don't cover pre-existing conditions, we cover it beautifully." — Face the Nation interview
- Reality check: Insurers may still have to cover them, but in states that get waivers, people with health conditions could be charged more if they didn't stay insured. And even Trump acknowledged that he wants to leave the ultimate decisions to the states: "If you hurt your knee, honestly, I'd rather have the federal government focused on North Korea, focused on other things, than your knee, okay?"
- The danger of higher premiums for 64-year-olds has been "totally fixed." — Face the Nation interview
- Reality check: The Congressional Budget Office warned that the new tax credit structure could leave the low-income elderly paying way more than they did under the Affordable Care Act. The White House pointed me to the changes made in the House manager's amendment, which would make the medical expenses deduction more generous. That's supposed to steer more money toward low-income seniors, but CBO hasn't finished analyzing the changes to make sure they actually help.
