I've spent the past couple of weeks up to my ears in 2025 annual healthcare policy rate filing analysis, so I haven't gotten around to addressing JD Vance's recent appearance on NBC in which he finally explained exactly what Donald Trump's "concept of a plan" for healthcare is:
When Donald Trump stammered at the recent presidential debate that he had “concepts of a plan” for Americans’ health care, he came across like a child who had forgotten his homework. But thanks to his campaign and his running mate JD Vance, we know now the Republican ticket really does have some “concepts.” Those concepts are bringing health care into the election — and presenting a tremendous opportunity to Vice President Kamala Harris.
Last Sunday, Vance raised the eyebrows of anyone familiar with health care policy when he told NBC’s Kristen Welker about Trump’s “deregulatory agenda.”
Project 2025, also known as the Presidential Transition Project, is a collection of conservative and right-wing policy proposals from the Heritage Foundation to reshape the United States federal government and consolidate executive power should the Republican Party candidate win the 2024 presidential election.
It proposes reclassifying tens of thousands of merit-based federal civil service workers as political appointees in order to replace them with those who will be more willing to enact the wishes of the next Republican president.
It asserts that the president has absolute power over the executive branch.
Critics of Project 2025 have characterized it as an authoritarian, Christian nationalist plan to transform the United States into an autocracy.
Since Donald Trump was defeated in the 2020 Presidential election, most people seemed to be under the impression that the Republican Party's decade-long obsession with tearing down President Obama's signature legislative accomplishment, the Patient Protection & Affordable Care Act, was finally over.
The 2024 ACA Open Enrollment Period is going on right now and will continue through January 16th in most states. So far, I've confirmed that over 4.7 million Americans have enrolled in either ACA exchange Qualified Health Plan (QHP) policies nationally or Basic Health Plan (BHP) policies in New York & Minnesota specifically; the odd are that the combined total will be over 18.5 million by the time the dust settles in January.
"The Democrats are the party that says government will make you smarter, taller, richer, and remove the crabgrass on your lawn. The Republicans are the party that says government doesn't work and then they get elected and prove it." --P.J. O'Rourke, Parliment of Whores
As I noted on Friday, Donald Trump's executive order essentially orders the incoming HHS Secretary (presumably Tom Price), along with other relevant agency heads, to do everything in their power to sabotage the ACA regardless of any repeal legislation (whether partial or total) on the part of Congress. Since the ACA grants the HHS Secretary pretty wide authority about how (and whether) to enforce various components of the law, this gives ample room for the Trump administration to make the individual mandate (among other ACA provisions) effectively meaningless.
Trump also issued a memo to all agencies requesting that they begin to "ease the burden of Obamacare as we transition from repeal to replace," Spicer said. He declined to provide specifics on what various agencies might do in response to the president's directive.
HOWEVER, David Anderson (formerly Richard Mayhew) notes that Section 2, which instructs the HHS Secretary to "waive, defer, grant exemptions from or delay" any "fiscal burdens" o sounds an awful lot like telling them to be absurdly lenient regarding granting "hardship exemptions" from the individual mandate:
@annaedney@ZTracer yes individual mandate exemptions will be passed out like pacifiers at a rave
IMPORTANT: I cannot guarantee accurate federal data after 1/20/17.
...HOWEVER, their bosses...the HHS Secretary and, I presume, the head of CMS...will be appointed by Donald J. Trump and confirmed by a 100% Republican-controlled Senate.
Given Trump's long, disturbing history of flat-out misstatements (aka "making sh*t up out of whole cloth"), and the type of sycophants he's likely to put into place, I can't guarantee with 100% certainty that the numbers spouted off by them are going to bear any connection with reality. Maybe they'll be accurate. Maybe they'll be off slightly. Maybe they'll be completely removed from any actual numbers. Who the hell knows?
Earlier today it was reported that Ben Carson was being considered for HHS Secretary. Then the rumor mill turned to Bobby Jindal. At the moment, I'm hearing it could be Rep. Tom Price, who (like pretty much every other GOP member of Congress) despises the ACA. That doesn't guarantee that he'll Make Sh*t Up, of course, but under a Trump regime, anything's possible. Anything.
STEPHANOPOULOS: You say that Ted Cruz is a liar, but you have said that you want everyone to be covered on health care and the government is going to pay for it. How is that not ObamaCare?
TRUMP: I want people takes -- that's true. I want people taken care of. I have a heart. I want people taken care of. If people have no money, we have to help people. But that doesn't mean single payer. It means we have to help people.
STEPHANOPOULOS: How do you do it?
TRUMP: We'll work something out.
And...scene.
(OK, I admit I left out some of Trump's blather before/after; feel free to click the link for his "fully detailed" response).