In last night’s speech to a joint session of Congress, President Trump didn’t shed much light on how he would go about replacing Obamacare. But he did say he had a plan that would simultaneously “expand choice, increase access, lower cost, and provide better healthcare,” and the few details he did provide suggest he might support Republicans’ plan to roll back the basic benefits that insurers are guaranteed to cover.
“The way to make health insurance available to everyone is to lower the cost of health insurance,” Trump said. Later, he said insurance plans “must be the plan [people] want, not the plan forced on them by the government.”
Though Trump didn’t spell it out, his rhetoric suggests he might be talking about “essential health benefits,” a set of 10 services that insurance plans are required to cover under Obamacare. These include things like lab tests, emergency care, and mental-health services. Before Obamacare, insurers could leave certain types of coverage out of their plans, and those plans were cheaper as a result.
Eliminating this “essential” package has become a typical Republican suggestion for health-care reform. At a breakfast with reporters last month, Representative Jim Jordan, a Republican from Ohio, said he wanted to “legalize inexpensive insurance,” and Senator Tim Scott of South Carolina has been quoted as saying, “In order for us to actually have real impact on making sure that this becomes a patient-centric approach to health care, we’re going to have to address those definitions, the essential benefits, giving more liberty and more flexibility for those definitions.” The draft House replacement bill leaked last week would also roll back these “essential” benefits, leaving them to the states to determine.