On the campaign trail, one of Donald Trump’s most oft-repeated promises was that he would repeal the Affordable Care Act, commonly known as Obamacare, and replace it with “something terrific.” This mythical, magical, secret plan was largely left to the imagination of voters, but he did make a few claims about what it would include.
Trump promised that his replacement would be “a lot less expensive” for consumers and for the government. “You know who makes the money with Obamacare? I don’t know if you know. The insurance companies,” he explained.
On 60 Minutes in September of 2015, Trump vowed that everyone would be covered if he won. “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”
Pressed for specifics, he explained that “people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything.”
Trump reiterated his pledge that every American would get coverage at a February 2016 MSNBC town hall. “We’re going to take care of them. We’re going to take care of them. We have to take care of them. Now, that’s not single payer. That’s not anything. That’s just human decency.”
“You will end up with great health care for a fraction of the price and that will take place immediately after we go in. Immediately! Fast! Quick!” he told supporters at a Las Vegas rally that month.
While he did not deliver that immediate savings in his first days as president, on Monday night, House Republicans released their Trumpcare proposal, the “American Health Care Act.” Tuesday, Trump took ownership of the proposal, calling it “Our wonderful new Healthcare Bill [sic]” in a 7:13 a.m. tweet.
The bill, in its current draft, does not do the things Trump promised. While it would provide a windfall for the insurance companies Trump once derided — including allowing a 30 percent surcharge for anyone who has had their coverage lapse and giving a tax credit to any insurance company that overpays its CEO — it could strip coverage from millions of Americans and provide far less help to poorer Americans seeking to buy insurance.
The bill would benefit richer Americans at the expense of the poor. With millions more uninsured, the savings to the government might be more short term than long, as the government will eventually have to pay some of the cost of their lack of care. And while younger people who are healthy might pay less, older people would likely have more expensive plans under this legislation.
While the proposed cuts will mean higher out-of-pocket costs for those who benefit from Obamacare’s subsidies, Rep. Jason Chaffetz (R-UT) has proposed that they could make up some of the difference by not buying iPhones.
Not all Republicans were thrilled with the proposal. Senators Rob Portman (R-OH), Shelley Moore Capito (R-WV), Cory Gardner (R-CO), and Lisa Murkowski (R-AK) released a letter objecting to its sharp cuts to Medicaid. Meanwhile, others objected to the bill for being too generous. Rep. Justin Amash (R-MI) derided it as “Obamacare 2.0,” while Sen. Rand Paul (R-KY) denounced it as being “Obamacare Lite.”
Trump has not yet publicly responded to their concerns, but did tweet to assure his support team at Fox & Friends that the bill was only the beginning.
In his first month in office, Trump broke 64 promises. By embracing this bill, he will be breaking several more.