Thread: Trump health-care agenda evolves toward core Republican thinking

Trump health-care agenda evolves toward core Republican thinking

President-elect Donald Trump speaks to the press following a meeting with Senate Majority Leader Mitch McConnell (R-Ky.) at the Capitol on Thursday. (Nicholas Kamm/AFP/Getty Images)

By Amy Goldstein November 11 at 5:30 PM

During the brief period since his election, President-elect Donald Trump has begun to revise his health-care agenda in ways that conform more closely to the heart of Republican thinking in recent decades.

On the presidential transition website, at greatagain.gov, anti-abortion statements and policy positions have appeared that were not part of the campaign’s health-care platform.

Other proposals have been deleted.

Erasing the Affordable Care Act and replacing it with a set of policies long favored by conservatives remain at the core of the agenda. But in his first interview as president-elect, Trump significantly softened his language for the ACA’s fate, telling the Wall Street Journal on Friday, “Either Obamacare will be amended or repealed and replaced.”

He mentioned just two parts of the law to keep, both favored by House Republicans despite their eagerness to axe the law.

Trump reiterated his support for a rule forbidding insurers to refuse coverage to people with preexisting medical problems.

And he said young adults should be able to stay on their parents insurance policies until 26 — an aspect he did not discuss during the campaign.

[Trump’s health-care positions as a candidate]

On the transition website, the first two lines in a set of bullet points say that the Trump administration will protect health-care workers from being required to perform services that violate their religious or moral beliefs and that it will “protect innocent human life from conception to natural death.” Neither had figured among the campaign’s health-care positions.

Trump has vowed to 'repeal and replace' Obamacare. Here's why it won't be so easy.
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Conversely, the website omits what had been the Republican nominee’s call for Congress to allow Americans to import prescription drugs from countries where they are sold at lower prices. This idea has long been favored by Democratic lawmakers but repeatedly blocked by Republicans.

The idea of drugs crossing U.S. borders could be construed as conflicting with the president-elect’s support of trade barriers, said Michael Cannon, director of health policy studies for the Cato Institute, a libertarian think tank. But Cannon acknowledged that, overall, Trump’s “health-care machinations have been a black box for me.”

According to insiders to the transition, the shifts in the agenda primarily reflect the views of people chosen to help handle his ascension to the Oval Office, not a deliberate strategy by Trump to align with the GOP majorities in the House and Senate.

[Is Paul Ryan already eyeing Medicare cuts?]

Many of the ideas, including the “conscience clause” for health-care workers, mirror the positions of the Heritage Foundation. Edwin Feulner, the conservative think tank’s former president, has a prominent role in the transition for domestic policy. So does Kenneth Blackwell, a former Cincinnati mayor and Ohio secretary of state who is a senior fellow at the Family Research Council and serves on boards of other conservative organizations.

The tweaked health-care agenda “is certainly moving in the direction of traditional Republican thinking,” said Gail Wilensky, a veteran health-policy expert who ran the Medicare and Medicaid programs under President George H.W. Bush and has not conferred with the Trump post-election team. “Not with a fulsome leap, but he’s definitely moved in that direction.”

During the campaign, for instance, the candidate’s platform did not address the future of Medicare, the vast federal insurance program for older or disabled Americans. The program has been strained financially for years, and the trust fund that pays for Medicare patients’ hospital care is forecast to become insolvent in a dozen years. Before his election, Trump said repeatedly that he would not cut or change the program. “I’m leaving it the way it is,” he said in May.

In contrast, the transition website says the Trump administration will “modernize Medicare so that it will be ready for the challenges with the coming retirement of the Baby Boom generation — and beyond.”

By adding Medicare modernization to the list, Trump is now employing the vocabulary of Republicans, notably House Speaker Paul D. Ryan (R-Wis.), Wilensky said. Ryan has long advocated converting Medicare from an entitlement program and giving its beneficiaries a certain amount of money to help buy private health plans.

For his part, Trump is borrowing “language that Ryan . . . has used about modernizing Medicare, but not with any specificity,” Wilensky said. She also noted that the president-elect’s time frame was slightly skewed, since the first baby boomers began to retire five years ago.

The president-elect’s agenda removes a separate campaign idea that the House speaker and other conservatives favor: changing tax law so that individuals can deduct the cost of health insurance. Critics say such a switch would weaken employer health benefits that have been the mainstay of coverage since the 1940s.

[Trump took five positions on abortion in three days]

Over the years, including early in his candidacy, Trump’s position on abortion has fluctuated. But in July, he chose Indiana Gov. Mike Pence, a fervent abortion opponent, as his running mate. Two months later, Trump dispatched a letter to “pro-life leaders” in which he pledged to nominate Supreme Court justices who oppose abortion rights, remove funding from Planned Parenthood and permanently institute the Hyde Amendment, a controversial provision that limits federal funding of abortion.

In Tuesday’s election, exit polls suggest about 80 percent of white, evangelical voters supported the Republican ticket.

https://www.washingtonpost.com/polit...492_story.html

Donald Trump, In Exclusive Interview, Tells WSJ He is Willing to Keep Parts of Health Law


By MONICA LANGLEY and
GERARD BAKER

Updated Nov. 11, 2016 5:53 p.m


NEW YORK—President-elect Donald Trump said he would consider leaving in place certain parts of the Affordable Care Act, an indication of possible compromise after a campaign in which he pledged repeatedly to repeal the 2010 health-care law.

In his first interview since his election earlier this week, Mr. Trump said one priority was moving “quickly” on President Barack Obama’s signature health initiative, which Mr. Trump said has become so unworkable and expensive that “you can’t use it.”
Yet, Mr. Trump also showed a willingness to preserve at least two provisions of the law after Mr. Obama asked him to reconsider repealing it during their meeting at the White House on Thursday.

Mr. Trump said he favors keeping the prohibition against insurers denying coverage because of patients’ existing conditions, and a provision that allows parents to provide years of additional coverage for children on their insurance policies.

“I like those very much,” Mr. Trump said.

Other urgent priorities during his first few weeks as president, Mr. Trump said, would be deregulating financial institutions to allow “banks to lend again,” and securing the border against drugs and illegal immigrants.


He said he would create jobs through nationwide infrastructure projects and improved international trade deals. He also said he would preserve American jobs by potentially imposing tariffs on products of U.S. companies that relocate overseas, thereby reducing the incentive to move plants abroad.


After a bitter campaign in which he came under criticism for his harsh and angry rhetoric, and a postelection period marked by anti-Trump protests in numerous cities, Mr. Trump said he is placing a high priority on bringing the country together.

“I want a country that loves each other,” Mr. Trump said. “I want to stress that.” He said the best way to ease tension would be to “bring in jobs.”


Asked whether he thought his rhetoric had gone too far in the campaign, Mr. Trump responded: “No. I won.”

Mr. Trump suggested he would now turn more positive, saying that was true of his victory speech early Wednesday morning, as well as his comments with Mr. Obama at the White House on Thursday. “It’s different now,” he said.


He deflected a question on whether he would follow up on a campaign vow to appoint a special prosecutor to investigate his election opponent, Democratic nominee Hillary Clinton, over her use of a private email server while she was secretary of state: “It’s not something I’ve given a lot of thought, because I want to solve health care, jobs, border control, tax reform.”


On health care, Mr. Trump said a big reason for his shift from his call for an all-out repeal was the meeting at the White House with Mr. Obama, who, he said, suggested areas of the Affordable Care Act, widely known as Obamacare, to preserve. “I told him I will look at his suggestions, and out of respect, I will do that,” Mr. Trump said in his Trump Tower office.


“Either Obamacare will be amended, or repealed and replaced,” Mr. Trump said.


The White House wouldn’t comment on Mr. Obama’s discussion with Mr. Trump on health care.


Mr. Trump declined to identify a single top priority upon taking office, saying: “I have a lot of first priorities.”


He did say, though, that he would rely heavily on his vice president-elect, Mike Pence, who had a decade of experience in Congress before becoming Indiana’s governor. “Mike will have a big role. He’s very capable,” Mr. Trump said.

He said he wanted Mr. Pence to handle “different areas of policy” and “be very much involved in health care.” He also said Mr. Pence would serve as his “liaison” with Congress, adding that Mr. Pence and House Speaker Paul Ryan of Wisconsin are friends.


On foreign affairs, Mr. Trump said he has heard from most leaders, though he hadn’t yet spoken with Chinese President Xi Jinping. He said he got a “beautiful” letter from Russian President Vladimir Putin, adding that a phone call between them is scheduled shortly.


Although he wasn’t specific, Mr. Trump suggested a shift away from what he said was the current Obama administration policy of attempting to find moderate Syrian opposition groups to support in the civil war there. “I’ve had an opposite view of many people regarding Syria,” he said.

He suggested a sharper focus on fighting Islamic State, or ISIS, in Syria, rather than on ousting Syrian President Bashar al-Assad. “My attitude was you’re fighting Syria, Syria is fighting ISIS, and you have to get rid of ISIS. Russia is now totally aligned with Syria, and now you have Iran, which is becoming powerful, because of us, is aligned with Syria. … Now we’re backing rebels against Syria, and we have no idea who these people are.”


If the U.S. attacks Mr. Assad, Mr. Trump said, “we end up fighting Russia, fighting Syria.”


On a different foreign hot spot, the Israel-Palestine situation, which Mr. Trump called “the war that never ends,” he said he hoped to help craft a resolution between them.

“That’s the ultimate deal,” Mr. Trump said. “As a deal maker, I’d like to do…the deal that can’t be made. And do it for humanity’s sake.”


On domestic policy, Mr. Trump said he is eager to focus on the 2010 Dodd-Frank financial-overhaul law, which he called “a tremendous burden to the banks.” He said: “We have to get rid of it or make it smaller.… Banks are unable to lend. It’s made our country noncompetitive. It’s slowed down growth.”


He said that people who have money haven’t been affected by the increased financial regulations. “I can borrow money,” Mr. Trump said. “The people who are really good, but need money to open a business or expand a business, can’t borrow money from the banks.”


http://www.wsj.com/articles/donald-trump-willing-to-keep-parts-of-health-law-1478895339

Trump needs to do this right, in order to keep the nation with him. He has had the right basic ideas. Yet, GOP regulars are homing in for their cut and jumping on the bandwagon for political points, ala Paul Ryan.