Tipsheet

Trump's Healthcare Plan: 'Obamacare on Steroids'?


I discussed Donald Trump's newly-released tax reform plan on Megyn Kelly's show last night, offering the assessment that his policy package offers much for conservatives to enthusiastically embrace. Despite being a consistent detractor of Trump's policy incoherence and boorish temperament, I'm not in the business of reflexively criticizing him for sport (via Right Sightings):


As I noted, there are plenty of applause-worthy elements within Trump's tax plan; for instance, reducing the number of income brackets, lowering and flattening rates, simplifying the code, and making America's sky-high corporate tax rate far more competitive. I chatted with conservative tax watchdog Grover Norquist yesterday, who described the proposals as "quite good," adding that any quibbles and flaws are easily outweighed by its benefits.  It's still prudent to look under the hood and press Trump on certain details pertaining to loophole elimination and promised revenue neutrality. Still, clearing aside his Warrenesque class warfare rhetoric and gimmickry, Trump's plan offers a series of solid, conservative, pro-growth reforms similar to the ideas put forth by other Republican candidates in the race. One can build a case that Trump's distasteful populist rhetorical and policy strokes are far more palatable -- or even justifiable -- when deployed in the service of advancing a broader set of systemic reforms.  All that being said, I called Trump a "Donnie come lately" to fiscal conservatism because his new set of proposals differs dramatically to the sort of confiscatory taxation policies he's advocated in the past.  The conservative Club for Growth issued a derisive press release in response to Trump's new white paper, effectively asking whether the Republican frontrunner would renounce his former self.  More importantly, the question of whether Trump has suddenly morphed into a lasting, reliable agent for conservative governance remains open, to put it charitably.  On that score, his discussion with 60 Minutes on healthcare policy raised myriad red flags, several of which Matt pointed out yesterday.  A number of Fox viewers challenged my "Obamacare on steroids" characterization, which I believe to be apt in light of Trump's remarks:

(1) "Everyone's got to be covered."  This call for universal coverage sounds like an endorsement of Obamacare's tent pole -- the hated individual mandate tax.  If he doesn't support that coercive, blanket measure, what is Trump's alternative to achieving his goal?

(2) Uninsured [poor] people are "going to be taken care of," he says.  Who pays for it?  "The government."  Conservatives have strenuously opposed Obamacare's expansion of Medicaid, an entitlement program that was already restricting access to care due to paltry reimbursement rates, and was empirically failing the neediest Americans.  Trump's comments suggest that he'd seek to extend Medicaid even further to cover millions of additional uninsured people, or perhaps propose some new program on top of the existing unsustainable federal healthcare bureaucracy.  Much like Obama, Trump claims that unspecified "savings" from elsewhere would pay for this enormous spending project -- but even if you grant him this point for the sake of argument, on what planet should the standard-bearer of the Republican Party and conservative movement make government-funded universal health coverage a centerpiece of his agenda?  Expanding the entitlement state and welcoming additional government intrusions into healthcare is the antithesis of limiting the size, scope and power of government.

(3)"It's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors."  This is almost precisely the way President Obama described the Obamacare exchanges, dressing up mandate-laden government micromanagement as "choice and competition" within the (extremely heavily regulated) private market.

Based on his own words, Donald Trump wants to rid the nation of the Obamacare "disaster," and replace it with what sounds like a bigger, more expensive version of Obamacare. Gabriel Malor points out that Trump even treads awfully close to repeating the president's infamous "keep your plan" promise, almost verbatim: "They can have their doctors, they can have plans, they can have everything." This was Democrats' Big Lie. Obamacare would allow satisfied Americans to maintain their current arrangements, they claimed, while covering millions of others, all while saving money -- no trade-offs, no downsides for anyone. "They can have everything" is irresponsible happy talk. If we won't accept it from Barack Obama, Harry Reid and Nancy Pelosi, we shouldn't accept it from Donald Trump either.