President-elect Donald Trump dodged a question during his January 11 press conference about how he plans to repeal and replace the Affordable Care Act (ACA) and whether or not the replacement plan would insure as many people, but he did indicate the attack on health care reform will be led by his nominee to run the Department of Health and Human Services (HHS), Rep. Tom Price (R-GA). In light of Trump’s delegation to Price, the media must do a better job of scrutinizing the devastating consequences of Price’s proposals than they have in the past
A Media Matters study of pre-election coverage found that prime-time cable and broadcast news failed to ask substantive questions about what Trump’s replacement for the ACA would look like. This cannot be the standard going forward.
On January 11, Trump held his first press conference in nearly six months and took questions on a variety of issues. A reporter asked Trump a two-part question about the future of Obamacare, first, asking for specifics on the timeline for the repeal and replacement of the ACA, and second, questioning whether or not Trump’s replacement would “guarantee coverage” for those who gained insurance under health care reform. During his three-minute answer, Trump provided no specifics on what policies the replacement package might include and dodged the question of whether or not it would maintain current levels of insurance coverage, instead insisting:
DONALD TRUMP: We're going to be submitting as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan. It‘ll be repeal and replace. It will be essentially simultaneously.
Trump’s answer, while not containing any policy specifics, did reveal two key things about the upcoming ACA fight.
First, Trump’s reluctance to answer whether or not his replacement will cover as many individuals as the ACA does is a trend, not an anomaly. As Vox senior editor Sarah Kliff and other reporters have noted, Republicans continue to dodge and obfuscate when pressed for details on how their ACA replacement will maintain the coverage expansions achieved since 2010. According to a December 15 article in The New York Times, a Republican congressional aide promised that the GOP plans would guarantee “universal access” of health care and coverage but provided no details about how this would improve on existing law.
Second, Trump’s claim that his administration would submit a plan “as soon as [his] secretary is approved,” seems to indicate that his replacement package would closely resemble the legislation authored by his HHS nominee, Tom Price. Price’s bill, the “Empowering Patients First Act,” is the most developed health care replacement of all the Republican plans. (After dozens of symbolic votes to repeal the ACA and six years of campaigning against the law, Price is the only congressional Republican to actually put a replacement plan together in legislative language.)
Price’s plan would gut access to health insurance in the U.S. and eliminate the essential health benefits package -- allowing insurers to determine whether or not things like maternity care should be covered. This dismantling of health care reform would benefit younger, healthier individuals while sending costs skyrocketing for older or sicker individuals. The plan would reinstate high-risk pools, endangering health care access for individuals with pre-existing conditions an ACA provision conservatives claim to want to preserve. Price’s bill would also rescind the ACA’s Medicaid expansion entirely and convert the program to a block grant, blocking access to care for many low-income communities. Additionally, as the HHS secretary, Price could unilaterally reverse the contraception mandate, a benefit he has dismissed because he claims he has yet to meet “one woman” who had trouble accessing birth control before the ACA. If enacted, Price’s “Empowering Patients First Act” would roll back the gains the Affordable Care Act has achieved, leaving millions more Americans uninsured -- as would most of the variants of “Trumpcare.”
Given that the incoming president suggested during his press conference that he will leave stewardship of repealing and replacing the ACA to his HHS secretary, journalists need to actively scrutinize Price’s record and his proposals for the future of American health care.
During the January 11 press conference, reporters asked just one question about the ACA, with zero attempts at a follow up, despite the fact that Trump functionally avoided the original question. The initial reporting on Price’s nomination whitewashed his history of opposition to reproductive health care, and largely failed to contextualize the potential impact of his proposed policies on the American health care system. Since Trump hinted at the major role Price might play in the upcoming ACA fight, it is incumbent on reporters to step up beyond their pre-election coverage and take the current job of vetting Price seriously, making clear the disastrous effects his proposals could have on the American health care system.