Trump’s America First Healthcare Plan

Executive Order on An America-First Healthcare Plan

The White House, September 24, 2020

Section 1. Purpose. Since January 20, 2017, my Administration has been committed to the goal of bringing great healthcare to the American people and putting patients first.

On December 22, 2017, I signed into law the repeal of the burdensome individual-mandate penalty…

Executive Order 13813 of October 12, 2017… My Administration increased the availability of renewable short-term, limited-duration healthcare plans… My Administration expanded health reimbursement arrangements… My Administration also issued a rule to increase the availability of association health plans…

Economic Report of the President (February 2020), my Administration’s expansion of health savings accounts…

my Administration acted to dramatically increase the accessibility and availability of telehealth services for Medicare beneficiaries…

waivers allow States to move away from the ACA’s rigid structure …

my Administration has paved the way for a new wave of innovation to allow patients to safely send their own medical records to care providers of their choosing…

CMS has acted to offer Medicare beneficiaries prescription drug plans with the option of insulin capped at $35 in out-of-pocket expenses…

Executive Order 13937 of July 24, 2020 low-income Americans who receive care from a federally qualified health center will have access to insulin and injectable epinephrine at prices lower than ever before…

Executive Order 13938 of July 24, 2020 my Administration will be the first to complete a rulemaking to authorize the safe importation of certain lower-cost prescription drugs from Canada…

Executive Order 13939 taking action to eliminate wasteful payments to middlemen by passing drug discounts through to patients…

Executive Order 13948 of September 13, 2020 ensure that Medicare patients receive the lowest price that drug companies offer comparable foreign nations…

Further Consolidated Appropriations Act, 2020, I also signed into law the repeal of the medical device tax, the annual fee on health-insurance providers, and the “Cadillac” tax on certain employer-sponsored health insurance…

Executive Order 13877 make sure patients have access to meaningful price and quality information prior to the delivery of care…

My Administration implemented a “site neutral” payment system between hospital outpatient departments and physicians’ offices…

The ACA is neither the best nor the only way to ensure that Americans who suffer from pre-existing conditions have access to health-insurance coverage. I have agreed with the States challenging the ACA, who have won in the Federal district court and court of appeals, that the ACA, as amended, exceeds the power of the Congress. The ACA was flawed from its inception and should be struck down. However, access to health insurance despite underlying health conditions should be maintained, even if the Supreme Court invalidates the unconstitutional, and largely harmful, ACA.

My Administration has always been committed to ensuring that patients with pre-existing conditions can obtain affordable healthcare, to lowering healthcare costs, to improving quality of care, and to enabling individuals to choose the healthcare that meets their needs.

My Administration has taken unprecedented action to improve the quality of and access to care for individuals with HIV, as part of our goal of ending the epidemic of HIV in the United States by 2030.

February 9, 2018, I signed into law the repeal of the Independent Payment Advisory Board…

October 24, 2018… billions of dollars of funding for important programs to support prevention and recovery…

June 6, 2018… improve options for veterans to receive care outside of Department of Veterans Affairs (VA) healthcare providers…

Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017… more power to discipline employees…

December 18, 2018… support for research into sickle cell disease…

In response to the COVID-19 pandemic, my Administration launched Operation Warp Speed…

Sec. 2. Policy. It has been and will continue to be the policy of the United States to give Americans seeking healthcare more choice, lower costs, and better care and to ensure that Americans with pre-existing conditions can obtain the insurance of their choice at affordable rates.

Sec. 3. Giving Americans More Choice in Healthcare. The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services shall maintain and build upon existing actions to expand access to and options for affordable healthcare.

Sec. 4. Lowering Healthcare Costs for Americans. (a) The Secretary of Health and Human Services, in coordination with the Commissioner of Food and Drugs, shall maintain and build upon existing actions to expand access to affordable medicines, including accelerating the approvals of new generic and biosimilar drugs and facilitating the safe importation of affordable prescription drugs from abroad.

Sec. 5. Providing Better Care to Americans. (a) The Secretary of Health and Human Services and the Secretary of Veterans Affairs shall maintain and build upon existing actions to improve quality in the delivery of care for veterans.

President Trump Delivers Remarks on the America First Healthcare Plan (video begins at 54 minutes):
https://www.youtube.com…

Comment:

By Don McCanne, M.D.

Although introduced with only limited fanfare, apparently the America First Healthcare Plan is the great health care plan that President Trump has been promising us. If you skim through the excerpts above, you’ll see that it is not much of a plan. The most significant change is to support the legal action to strike down the Affordable Care Act. The most highly emphasized positive measure is to establish as official U.S. policy “that Americans with pre-existing conditions can obtain the insurance of their choice,” though no mechanism is established to implement that policy once the Affordable Care Act is struck down. The majority of the measures are actually detrimental. His trademark dishonesty permeates his speech (even throwing in a gratuitous use of the term “communists”).

President Trump has not offered a credible “Replace” plan once the Affordable Care Act is eliminated. But Joe Biden’s proposal to merely tweak the current system is unsatisfactory as well, though not to as great of a degree. (And there are other issues that make this election important.)

We desperately need single payer, improved Medicare for All. Does anyone see a clear path forward from here?

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