On Monday, in a meeting with the nation’s governors, President Trump conceded that he had not been aware of the complexities of health care policy-making: “I have to tell you, it’s an unbelievably complex subject. Nobody knew that health care could be so complicated.” Trump also suggested that the struggle to replace the Affordable Care Act was creating a legislative logjam that could delay other parts of his political agenda.
Many policy makers had anticipated the intricacies of changing the health care law, and Mr. Trump’s demands in the opening days of his administration to simultaneously repeal and replace former President Obama’s signature domestic achievement made the political calculations far more complicated.
Governors of both parties added still more confusion on Monday when they called for any replacement to cover all the people already benefiting from the landmark law.
“Of course I am concerned,” said Gov. Brian Sandoval, the Republican governor of Nevada, where about 300,000 people have gained Medicaid coverage. “I am someone who elected to expand Medicaid. That’s been very beneficial to my state, and I want to be sure those individuals can keep their coverage.”
“Governors are all in agreement,” said Gov. Terry McAuliffe of Virginia, a Democrat who is the chairman of the National Governors Association. “We do not want one single one of our citizens to lose access to quality health care. We are all unified on that. Actually, we want to expand, so everybody has access to quality health care.”
Yet, the President brushed aside opinion polls suggesting that the 2010 health law was becoming somewhat more popular. “People hate it,” he said, “but now they see that the end is coming and they’re saying, ‘Oh, maybe we love it.’ There’s nothing to love. It’s a disaster, folks.”
“Statutorily and for budget purposes, as you know, we have to do health care before we do the tax cut,” Trump told governors.
After his session with the governors, Trump met with executives from health insurance companies on Monday. He apparently hopes they will stay in or return to the Affordable Care Act’s insurance marketplaces, where more than 10 million people obtained coverage last year.
Great meeting with CEOs of leading U.S. health insurance companies who provide great healthcare to the American people. pic.twitter.com/s2NMVMvQq3
— Donald J. Trump (@realDonaldTrump) February 27, 2017
To help people buy insurance, if they do not have coverage at work or under a government program, the bill would offer tax credits ranging from $2,000 to $4,000 a year, depending on age. However, the credits would not fluctuate with a recipient’s income, raising the prospect that insurance might be less affordable for those who fall into the lower-income bracket. The House Republican bill would also eliminate minimum federal standards for “essential health benefits,” and it could require some people with particularly expensive employer-sponsored coverage to pay taxes on some of its value.