Trump Lays Out Guiding Principles for Healthcare Reform

During President Donald Trump’s first address to Congress, his call for Congress to repeal and replace the Affordable Care Act (ACA) was met with one of the speech's longest and loudest rounds of applause from Republicans.

The president laid out his vision for the future of healthcare: expanded choice, increased access, lower cost, and better healthcare.

“Mandating every American to buy government-approved health insurance was never the right solution for our country,” Trump said. “The way to make health insurance available to everyone is to lower the cost of health insurance and that is what we’re going to do.”

He then took time to outline how he sees the ACA as being unsustainable, citing double- and triple-digit premium increases nationwide. He cited Republican Governor Matt Bevin of Kentucky, who has said that one-third of his commonwealth's counties have only a single insurer on the exchange, called Kynect.

“Obamacare is collapsing and we must act decisively to protect all Americans,” Trump said. “Action is not a choice, it is a necessity. I’m calling on all Democrats and all Republicans to work with us to save Americans from this imploding Obamacare disaster.”

He then took the time to lay out his guiding principles for Congress as it moves to create a better healthcare system:

1. Americans with preexisting conditions should have access to coverage, and there should be a stable transition for Americans currently enrolled in the healthcare exchanges.
2. Tax credits and expanded health savings accounts should be used to help Americans purchase their own coverage and a plan they want.
3. State governors should be given resources and flexibility with regard to Medicaid to ensure no one is left out.
4. Legal reforms should protect patients and doctors from unnecessary costs that drive up the price of insurance, and there must be work to bring down the high cost of drugs. This point was one of the rare few comments that receive a bipartisan applause.
5. Americans should have the freedom to purchase health insurance across state lines, which he said, "will create a truly competitive national marketplace that will bring costs way down and provide better care—so important.”

Trump also mentioned that he wanted to work to make child care accessible and affordable, provide new parents with family leave, invest in women’s health, and promote clean air and water.

“Everything that is broken in our country can be fixed,” Trump said. “Every problem can be solved. And every hurting family can find healing, and hope.”

The president’s address was followed by the Democrats’ response, which was delivered by Steve Beshear, the former governor of Kentucky who oversaw the implementation of Kynect, the insurance exchange set up under the ACA to serve the commonwealth. As governor, Beshear also expanded Medicaid.

Beshear delivered his remarks from a diner in Lexington, Kentucky, sitting at a table and surrounded by residents.

He called out the president on claiming to be a champion for families struggling to make ends meet and then rolling back rules that provide oversight of the financial industry and making it harder to afford a mortgage. In addition, he noted that Trump and Republicans in Congress are determined to “rip affordable health insurance” away from families through a repeal of the ACA.

“Does the Affordable Care Act need some repairs? Sure it does,” Beshear said. “But so far, every Republican idea to replace the Affordable Care Act would reduce the number of Americans covered, despite your promises to the contrary.”

He said that Republican plans promise access, but would charge people more for fewer benefits. Before the ACA, people without health insurance worried that a bad diagnosis could lead to bankruptcy.

“You know, in 2010, this country made a commitment that every American deserved healthcare they could afford and rely on,” Beshear said. “And we Democrats are going to do everything in our power to keep President Trump and the Republican Congress from reneging on that commitment.”