The Mercury News

Trump: ‘Insurance for all’

President-elect says he has a plan to replace Affordable Care Act

- By Robert Costa and Amy Goldstein

President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Barack Obama’s signature health care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.

Trump declined to reveal specifics in the telephone interview with The Washington Post, but any proposals from the incoming president would almost certainly dominate the Republican effort to overhaul federal health policy as he prepares to work with his party’s congressio­nal majorities.

Trump’s plan is likely to face questions from the right, following years of GOP opposition to further expansion of government involvemen­t in the health care system, and from those on the left, who see his ideas as disruptive to changes brought by the Affordable Care Act that have extended coverage to millions.

In addition to his replacemen­t plan for the ACA, also known as “Obamacare,” Trump said he will target pharmaceut­ical companies over drug prices and demand that they negotiate directly with Medicaid and Medicare.

The objectives of broadening access to insurance and lowering health care costs have always been in conflict, and it remains unclear how the plan that the incoming administra­tion is designing — or ones that will emerge on Capitol Hill — would address that tension.

Congressio­nal GOP plans to replace Obamacare have tended to try to constrain costs by reducing government requiremen­ts, such as the medical services that must be provided under health plans sold through the law’s marketplac­es and through states’ Medicaid programs. House Speaker Paul Ryan and other Republican­s have been talking about providing “universal access” to health insurance, instead of universal coverage.

Trump said he expects Republican­s in Congress to move quickly and in unison in the coming weeks on other priorities as well, including enacting sweeping tax cuts and beginning the building of a wall along the Mexican border.

Trump warned Republican­s that if the party splinters or slows his agenda, he is ready to use the power of the presidency — and Twitter — to usher his legislatio­n to passage.

Trump said his plan for replacing most aspects of Obama’s health care law is all but finished. Although he was coy about its details, he said he is ready to unveil it alongside Ryan and Senate Majority Leader Mitch McConnell, R-Ky.

“It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon,” Trump said. He noted that he is waiting for his nominee for secretary of health and human services, Rep. Tom Price, R-Ga., to be confirmed.

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