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(CNN) – President Donald Trump is promoting what he calls his “vision” of health care, but the executive orders he plans to sign Thursday afternoon are largely aimed at addressing two major problems facing Americans.
The measures, which are far from being a comprehensive proposal, come less than six weeks before the presidential election and serve as a political game to shore up concerns in a changing state event. Democratic nominee Joe Biden has already pledged to make healthcare a focal point for the rest of his campaign, highlighting Trump’s actions to dismantle the Affordable Care Act and the unprecedented protections the law already provides. to people with pre-existing conditions.
The president also seeks to deflect attention from criticism of his handling of the coronavirus pandemic. More than 200,000 Americans have died from the virus in the past six months.
The first executive order will state that it is United States policy that people suffering from pre-existing conditions be protected, the president said. Any legislation Congress sends to your desk must include this provision, he said.
“We’re putting it on a stamp, because our opponents, the Democrats, like to constantly talk about it, and yet the pre-existing conditions are much safer with us than they are,” Trump said. “And now we have it affirmed. This is affirmed, signed and done. Then we can leave that.”
The president and Republican lawmakers have repeatedly said they will protect these Americans, even as they try to overturn the Affordable Care Act that already protects them. In a call with reporters, Health and Human Services Secretary Alex Azar declined to specify how the administration would guarantee these protections if the Supreme Court overturns the historic health reform law in a case that will consider this term.
The second executive order directs Congress to pass legislation to address surprise medical billing before the end of the year, and if lawmakers fail to do so, Azar will seek to do so through executive or regulatory action.
Trump already called for an end to the practice in a 2019 speech and in his State of the Union address earlier this year. Although lawmakers on both sides of the aisle agree, the legislation has been hampered by different views on who should cover the bill: insurers or providers.
Although the president has repeatedly promised to implement a health care proposal, the administration has decided to bill the wide variety of measures that Trump has taken as his vision.
In his speech, Trump introduced what he calls his America First Health Plan, which includes many measures that his administration introduced during his first term, some of which have been enacted, but others remain proposed or tied to the courts. Among them: Expanding less costly alternatives to the Affordable Care Act, requiring hospitals to disclose negotiating prices, reducing insulin costs for seniors, and improving kidney health. He also noted that Americans insured through Medicare Advantage have seen their premiums drop.
Trump also said seniors will receive $ 200 cards in the coming weeks to help them buy prescription drugs.
A senior administration official told CNN that the money will come in the form of discount cards for prescription drug copays.
The official said the cost of the cards will be offset by savings from Trump’s recent “favored nations” executive action, which requires Medicare to try to pay the same price for certain expensive prescription drugs as other developed countries.
Funding for the cards will come from the Centers for Medicare & Medicaid Services as a designated Medicare demonstration project.
The orders are the latest healthcare-related actions Trump has taken in recent weeks as he seeks to regain control of the Biden problem. Healthcare returned to the limelight with the death of Supreme Court Justice Ruth Bader Ginsburg on Friday, adding to uncertainty around the fate of the Affordable Care Act in court. highest in the nation. The magistrates will hear oral arguments on a case seeking to repeal the law on November 10, a week after the elections. The Trump administration has asked the court to invalidate Obamacare.
Protecting those with pre-existing conditions
The Affordable Care Act protections for those with pre-existing conditions have proven to be one of its most popular provisions. Defending the law by Democrats helped them take control of the House in 2018.
The protections include prohibiting insurers from denying coverage or charging higher premiums to people based on their medical history, both common practices in the individual market prior to Obamacare. An estimated 54 million Americans, or 27% of adults who are not elderly, have conditions that would have made them uninsurable under the old system, according to the Kaiser Family Foundation.
The law also requires insurers to provide comprehensive benefits in the individual market and prohibits them from imposing annual or lifetime limits on coverage.
Although the president has repeatedly said that he will continue with these protections, his actions say otherwise. The administration largely backs a Republican-led coalition of state attorneys general, who say Obamacare’s individual mandate became unconstitutional when Congress lowered the penalty for not having insurance to zero in 2017. As a result, the entire law must fall, they argue. . This case is now before the Supreme Court.
Administration officials also maintain that Obamacare does not truly protect people with pre-existing conditions because their premiums and deductibles are unaffordable. However, Trump’s alternative, short-term health plans, which he expanded through an executive order in 2017, come with lower monthly premiums in large part because these policies do not have to comply with Health Law regulations. Affordable Health Care.
Furthermore, the president’s efforts to continue the protections do little to help people pay for health insurance in the event that Obamacare is declared unconstitutional. The law provides generous subsidies to low- and moderate-income Americans to purchase policies on Affordable Care Act exchanges and supports states expanding Medicaid to low-income adults. Some 38 states, plus the District of Columbia, have expanded Medicaid or passed ballot measures to do so.
Surprise medical billing completion
The president has also spoken several about how to solve the problem of surprise medical billing, another of the great concerns of Americans in the matter of health care.
Patients are often affected by surprise medical bills when they receive emergency care from an out-of-network provider they did not choose. About 1 in 6 emergency room visits or hospital stays generated at least one out-of-network bill in 2017, according to the Kaiser Family Foundation.
Efforts to address the issue in Congress have stalled amid a publicity blitz and lobbying by the health care industry. Insurers favor the government setting a benchmark rate, but hospitals and other providers, often backed by private equity firms, strongly support resolution of the matter through arbitration.
Proposals to lower drug prices
In recent weeks, the president has sought to renew attention on his efforts to lower drug prices, one of the main promises of his campaign and first term. The high cost of prescription drugs has long been a top health care complaint for Americans.
He has issued four executive orders since the end of July that largely recycle controversial ideas his administration has proposed in the past, including importing less expensive drugs from Canada and basing the cost of certain Medicare drugs on their prices in other developed nations. .
But his measures, which also included calling drug manufacturers on Twitter, have not resulted in a reduction in drug prices, although the rate of price growth slowed between 2015 and 2019. Manufacturers increased prices of 857 drugs by an average of 6.8% in the first six months of this year, according to GoodRx, which follows several thousand brand-name and generic drugs.
The administration is also committed to providing consumers with more information on healthcare prices as a way to monitor their growth. Officials issued a landmark rule in November requiring hospitals to disclose prices that they negotiate privately with insurers. The move stems from an executive order Trump issued in the summer of 2019. A district court judge this summer rejected an attempt by a coalition of hospital groups to block the rule, although hospitals have filed an appeal.
Trump officials have also proposed a separate rule that would require insurers to provide consumers with estimates of their out-of-pocket costs for all health care services through an online tool. However, some experts say the rules will not help many consumers because people often do not buy medical services.
This story was first published on CNN.com, “Trump’s Healthcare ‘Vision’ Stands on Two Big Issues.”
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