What Trump might really do with health care
WASHINGTON — President-elect Donald Trump has said he may keep some parts of his predecessor’s signature health care overhaul. No final decisions have been made. Based on interviews with congressional Republicans, here’s a general idea of what goes, what may stay, and what’s in doubt:
-Mandates on individuals to get coverage or risk fines from the IRS.
-Mandates on employers to cover workers.
-All or most of the Affordable Care Act’s tax increases on upper-income individuals and the health care industry.
-Limits on what insurers can charge older customers. Leading Republicans want to loosen them.
– Letting young adults stay on parental health plans until they turn 26.
– A ban on lifetime dollar limits for insurance coverage.
– Some kind of system to protect people with health problems from being denied coverage. The new approach may include a requirement that people maintain “continuous” coverage, which has yet to be legally defined. The government would also fund “high risk” insurance pools for patients who fall through the cracks.
– Tax credits or tax deductions to help people pay their premiums. The form and level of that assistance is unclear.
WHAT’S IN DOUBT
-The Medicaid expansion in President Barack Obama’s law, which has provided coverage to an estimated 9 million low-income people. A number of Republican governors have accepted it, and more may want to do so now that the law will no longer be so closely associated with Obama. Most prominent among the GOP governors expanding Medicaid: Mike Pence. Medicaid expansion is a key piece of the puzzle.
– Current rules that require women employees of religious-affiliated institutions such as colleges, hospitals and charities, to be offered coverage for contraceptives as a free preventive health benefit. The Trump administration could move to rescind those rules on its own with congressional approval.
– The future of online insurance markets like HealthCare.gov, which serve people who don’t have access to job-based coverage.
-Some kind of new limit on the tax-free status of employer-provided health insurance, applying to the most generous plans. It would replace the health care law’s widely opposed “Cadillac Tax.”