- Chip Somodevilla/Getty Images
President Donald Trump has promised to deliver better healthcare at a lower cost while allowing every American access to coverage, raising the stakes in how he will address the future of healthcare in the US.
In an interview with ABC News’ David Muir that was broadcast Wednesday night, Trump said the Affordable Care Act, the healthcare law better known as Obamacare, was a disaster – a line Trump had used before his election and has used since.
“It’s too expensive,” Trump told Muir. “It’s horrible healthcare. It doesn’t cover what you have to cover. It’s a disaster. You know it and I know it.”
Trump also correctly pointed out that certain states – he cited Arizona and Minnesota – were seeing large increases in premiums on the individual market exchanges established by the ACA.
In response, Trump made numerous promises about what he said the Obamacare replacement would entail.
He said he wanted “good coverage at much less cost” and “a much better healthcare plan at much less money.”
Yet perhaps the largest promise from Trump was the number of people he suggested his replacement would cover. Since the ACA’s passage, more than 20 million Americans have gained access to health insurance, and the US uninsured rate has hit its lowest point ever.
Despite these gains, Trump said he didn’t think the ACA had provided enough people with coverage. He told Muir his replacement would cover those the ACA had not.
“It’s going to be – what my plan is is that I want to take care of everybody,” Trump said. “I’m not going to leave the lower 20% that can’t afford insurance.” (Only about 10% of the US population currently does not have coverage.)
Trump reiterated his promise later in the interview.
“So I want to make sure that nobody’s dying on the streets when I’m president,” Trump said. “Nobody’s going to be dying on the streets. We will unleash something that’s going to be terrific.”
Muir pressed the president on whether a replacement would mean that no one who had gained coverage because of the ACA would lose it.
“We want no one. We want the answer to be no one,” Trump said, though he acknowledged that such a feat would be difficult.
So far, a flurry of proposals put forward by Republicans – including two Senate bills introduced by GOP lawmakers in the past week – do not appear to maintain coverage for all Americans with coverage under the ACA, much less guarantee it for all Americans.
Most congressional Republicans – including House Speaker Paul Ryan and Trump’s pick for secretary of health and human services, Rep. Tom Price – have talked about providing “access” to coverage for all Americans but have stopped short of promising that all people will have coverage.
Health-policy analysts have said these three promises are also in conflict with one another. To expand coverage – especially to every single American – the cost to the government would have to increase, not decrease, to fund tax credits and coverage-expansion programs.
Republicans have begun repealing the ACA and are in Philadelphia over the next few days to, among other things, craft a replacement.