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Meet the ACAlternatives: Your potential Obamacare replacements

Carolyn Kaster, Associated Press

(Carolyn Kaster, Associated Press)

Days before taking office, President-Elect Donald Trump is offering additional clues about how he intends to replace Obamacare following the widely-anticipated repeal.

“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it,” he told the Washington Post. “That’s not going to happen with us.”

Trump also wants the government to negotiate lower prescription drug prices, and for more pharmaceutical companies to do their manufacturing in the U.S. It is unclear how he plans to accomplish this, or if the unpopular individual mandate will persist. The provision that covers young people on their parents’ insurance plan until age 26 will also be up for debate.

Dr. Tom Price, former Congressman and incoming Secretary of Health and Human Services, will be a key player in both shaping and implementing the new health care policy. Price has plans of his own, which he introduced in Congress during his last term.

The Empowering Patients First Act would have provided people under age 35 and over age 50 with a tax credit to help them buy health insurance. Are you young, healthy, and broke? You won’t have to buy insurance under Price’s plan, which abolishes the individual mandate.  

Price’s plan protects insurance customers from pre-existing condition exclusions and the dreaded spike in insurance premiums that can accompany serious illness – only if the person is insured before illness strikes.

“So long as you stay insured, insurers can’t impose either pre-existing condition exclusions or raise your premiums because you have expensive medical conditions,” Forbes‘s Seth Chandler explains. “[However,] if you haven’t kept up your health insurance purchases… an insurer is free to impose pre-existing condition exclusions for up to 18 months [and] to raise your premiums up to 50% for up to three years.”

Congressman Rand Paul (R-KY) has a more libertarian solution in mind. Paul’s plan would remove the Obamacare requirements on what conditions and procedures insurance must cover. Part of the spike in premiums is a result of the Affordable Care Act’s requirement that all insurance policies cover more conditions. Instead of the government determining what plans a company can offer, the free(ish) market will determine what plans are available.

Millennials – with the least medical needs and the least money of all living adult generations – will likely opt for catastrophic care plans. These plans cost much less than standard plans because they cover only very serious illnesses.

Trump’s, Price’s, and Paul’s plans all aim to provide greater coverage at lower prices. It remains to be seen if, and how, Republicans will iron out the details and reach consensus on a policy to replace the Affordable Care Act.


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