Julie Appleby, KFF Health News
Donald Trump may have destroyed the Affordable Care Act, however “he chose to build upon [it].”
Sen. JD Vance (R-Ohio) on “Meet the Press,” Sept. 15
Sen. JD Vance (R-Ohio) on Sept. 15 informed viewers of NBC’s “Meet the Press” that former President Donald Trump constructed up the Affordable Care Act, despite the fact that Trump may have chosen to do the alternative.
“Donald Trump had two choices,” Vance, Trump’s working mate, mentioned. “He could have destroyed the program, or he could actually build upon it and make it better so that Americans didn’t lose a lot of health care. He chose to build upon a plan, even though it came from his Democratic predecessor.”
The remarks comply with statements the previous president made throughout his Sept. 10 debate with Vice President Kamala Harris in Philadelphia. Trump mentioned of the ACA, “I saved it.”
The Affordable Care Act, aka Obamacare, has grown more popular as Americans have more and more used it to achieve well being protection. More than 20 million people enrolled this yr in plans offered by way of the marketplaces it created. That makes the legislation a tough political subject for Republicans, who’ve largely retreated from their makes an attempt over the previous decade to repeal it.
Both Vance’s and Trump’s statements are false. We contacted Vance’s marketing campaign; it supplied no extra info. But right here’s a overview of insurance policies associated to Obamacare that Trump pursued as president.
So What Did Trump Do With the ACA?
Most of the Trump administration’s ACA-related actions concerned slicing this system, together with lowering by thousands and thousands of {dollars} funding for marketing and enrollment assistance and backing the numerous failed efforts in Congress and the courts to overturn the legislation. In June 2020, for instance, the administration asked the Supreme Court to overturn the legislation in a case introduced by greater than a dozen GOP states. The excessive court docket finally rejected the case.
“The fact the ACA survived the Trump administration is a testament to the strength of the underlying statutory framework, and that the public rallied around it,” mentioned Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.
Most ACA provisions took impact in 2014, throughout Barack Obama’s presidential administration.
Average premium prices, already rising when Trump took workplace, jumped for some plans in 2018, earlier than starting a modest decline for the remainder of his time period, according to statistics from KFF, a well being info nonprofit that features KFF Health News.
Some of these will increase had been tied to a 2017 Trump administration resolution to cease making funds to insurers, which was meant to cut back deductibles and copayments for folks with low to average incomes. By legislation, although, insurers nonetheless needed to supply the plans.
Two months earlier, the Congressional Budget Office warned that stopping the funds may trigger some insurers to depart the ACA market — and that premiums would rise by 20% within the first yr.
Most states, nonetheless, let insurers make up for the misplaced funds by growing month-to-month premiums. That had the unintended impact of boosting federal subsidies for individuals who purchase Obamacare plans, as a result of the subsidies are tied to the price of premiums.
“By accident, that gave people cheaper access to better coverage in the exchange plans,” mentioned Joe Antos, a senior fellow emeritus with the American Enterprise Institute.
Some Republicans assume Trump deserves credit score for this inadvertent enchancment.
But Larry Levitt, KFF’s govt vice chairman for well being coverage, mentioned that wasn’t the Trump administration’s intention.
“The one time when Trump improved the ACA, it was an unintended consequence of an attempt to weaken it,” he mentioned.
Meanwhile, the Trump administration expanded entry to some sorts of cheaper well being protection that aren’t compliant with ACA guidelines, together with short-term plans that typically have extra restrictions on care and may go away shoppers with shock medical payments. Democrats name the plans “junk insurance.”
Brian Blase, president of the Paragon Health Institute, a conservative well being analysis group, mentioned broader entry to cheaper, much less complete plans helped extra folks get protection. The plans’ critics say that if they’d attracted too many wholesome folks from ACA-compliant insurance coverage, will increase may have spiked for individuals who remained.
Trump additionally supported congressional repeal-and-replace efforts, all of which failed — together with on the memorable evening when Sen. John McCain (R-Ariz.) helped kill the hassle with a thumbs-down vote. The Trump administration by no means issued its personal alternative plan, regardless of the previous president’s many promises that he would.
Trump, throughout the debate with Harris, mentioned that he has “concepts of a plan” to interchange Obamacare and that “you’ll be hearing about it in the not-too-distant future.”
On “Meet the Press,” host Kristen Welker requested Vance when Trump’s plan can be prepared. He didn’t reply straight however mentioned it could contain “deregulating the insurance market.”
Critics say that’s code for letting insurers do enterprise as they did pre-ACA, when sick folks may very well be denied protection or charged exorbitant premiums based mostly on preexisting situations.
Our Ruling
Vance’s assertion that Trump as president took steps to construct upon the ACA and defend the well being protection of 20 million Americans is solely not supported by the document.
Trump administration insurance policies, for instance, didn’t buttress the ACA however usually undermined enrollment outreach efforts or had been superior to sabotage the insurance coverage market. Also, Trump vocally supported congressional efforts to overturn the legislation and authorized challenges to it.
By the numbers, Affordable Care Act enrollment declined by greater than 2 million folks throughout Trump’s presidency, and the number of uninsured Americans rose by 2.3 million, together with 726,000 youngsters, from 2016 to 2019, based on the U.S. Census Bureau. That consists of practically three years of Trump’s presidency.
We fee Vance’s assertion False.
SOURCES:
“Meet the Press” interview with Sen. JD Vance, Sept. 15, 2024.
Brookings Institution, “Six Ways Trump Has Sabotaged the Affordable Care Act,” Oct. 9, 2020.
Vox, “Trump Is Slashing Obamacare’s Advertising Budget by 90%,” Aug. 31, 2017.
Center on Budget and Policy Priorities, “Trump Administration Has Cut Navigator Funding by Over 80 Percent Since 2016,” Sept. 13, 2018.
The New York Times, ‘Trump Administration Asks Supreme Court To Strike Down Affordable Care Act,” June 26, 2020.
Constitutional Accountability Center, Texas v. United States, accessed Sept. 16, 2024.
Harvard T.H. Chan School of Public Health, “Quantifying Health Coverage Losses Under Trump,” Nov. 3, 2020.
Center on Budget and Policy Priorities, “Uninsured Rate Rose Again In 2019, Further Eroding Earlier Progress,” Sept. 15, 2020.
U.S. Census Bureau, Health Insurance Historical Tables, revised Aug. 22, 2024.
KFF, Marketplace Average Benchmark Premiums, accessed Sept. 16, 2024.
Brookings Institution, “The Case for Replacing ‘Silver Loading,’” May 20, 2021.
KFF Health News, “Trump Administration Loosens Restrictions on Short-Term Health Plans,” Aug. 1, 2018.
The New York Times, “Biden Administration Finalizes Rule Curbing Use of Short-Term Health Plans,” March 28, 2024.
Telephone interview, Sabrina Corlette, co-director of the Center on Health Reforms at Georgetown University, Sept. 16, 2024.
Telephone interview, Joe Antos, senior fellow emeritus, American Enterprise Institute, Sept. 16, 2024.
Email correspondence, Brian Blase, president of the Paragon Health Institute, Sept. 16, 2024.
Email correspondence, Larry Levitt, KFF govt vice chairman for well being coverage, Sept. 18, 2024.
Congressional Budget Office, “The Effects of Terminating Payments for Cost-Sharing Reductions,” Aug. 15, 2017.
USA Today, “Trump To End Cost-Sharing Subsidies to Insurance Companies,” Oct. 12, 2017.
New York journal, “Vance: Trump’s Health-Care Plan Is To Let Insurers Charge More for Preexisting Conditions,” Sept. 17, 2024.