Donald Trump’s victory could mean big, immediate changes in how the U.S. federal government approaches health policy, along with smaller, slower changes in federal health laws, regulations and programs.
Trump has said, repeatedly, that he wants to repeal and replace the Affordable Care Act.
Trump has talked about replacing the ACA with a combination of an expanded health savings account program, interstate sales of health insurance, and a subsidized risk pool program for people with health problems.
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During Wednesday’s victory speech, Trump thanked Dr. Ben Carson, a surgeon who was a strong advocate of making expanded health savings accounts the core of an ACA alternative.
Trump has also talked during the recent presidential debates and at campaign events about wanting to replace the current, federally driven Medicaid funding system that would rely more on block grants, or giving states fixed amounts of cash and letting them decide how to spend the cash.
At other points, Trump has said that he wants to preserve Medicare benefits for the elderly and increase spending on Alzheimer’s research.
Drafters of several Republican ACA replacement proposals, such as the Sessions-Cassidy proposal, have talked about keeping some of the more popular ACA consumer protection provisions, such as the mandate requiring insurers to offer parents a chance to keep young adults on their health coverage up to age 26, and at least some kind of one-time access to major medical coverage on a guaranteed-issue basis.
Some of the proposals would give states the option of keeping their ACA exchange.
All of the Republican ACA replacement proposals have called for eliminvating the ACA provision that requires many individuals to own health coverage, and the ACA provision that requires many employers to offer health coverage.
The official Republican Party platform calls for providing more support for helping people who need long-term care stay in their own homes.
Obstacles, and opportunities
One big obstacle a Trump administration would face is, Republicans have only a slim lead in the Senate.