Guest MINDSETTER™ Gardiner: Measure President Trump by Healthcare Reform
Friday, November 11, 2016
Thanks to a rustbelt revolution, on Friday, Jan. 20, 2017 Donald J. Trump will be sworn in as the 45th President of the United States. Trump’s insistence on better trade deals and willingness to pull back from bad deals was music to the ears of America’s workers. Americans and our immigrants, persons of all races and creeds, love and live for their families. A decent full time paycheck in a skilled job or position makes that possible for many. We all share that. Weeks ago Trump said “we want a young economy.” Amen I thought. We all do.
President-Elect Trump starts with majorities in the House and Senate and a strong claim to a mandate particularly on tax cuts and to repeal and replace Obamacare. Plans for a great infrastructure re-building, taking care of veterans, all must be paid for. President-Elect Trump's promised tax cuts and the repeal and replacement of Obamacare are the core of his economic program, the engine of growth that could pay the bills.
Enacting tax cuts in the first 100 days is almost assured. In August, Trump had already met with the Chair of the House Ways and Means Committee and there appears to be agreement on three rates for individuals, 0-12% for lower income, a mid-range bracket of 25% and a cap of 25% on pass through business income, such as that earned by sole proprietors, partners, and Subchapter S taxpayers. An expanded standard deduction will help everyone, and the top rate will be 33%. The corporate rate tax rate will be cut to 15% to mitigate corporate departure from the U.S. Tax cuts are not in doubt. The more difficult task, performed responsibly, will be repealing and replacing Obamacare gracefully.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTObamacare is not affordable for the middle class. And it’s projected that by 2024 one in five dollars spent in the U.S. will be on healthcare. Surely we should try to do better. Trump promised to repeal Obamacare, Hillary dug in, but Trump made the right call. Late in October, the Obama Administration confirmed news of double digit increases in the cost of “Affordable” insurance all over the country. Some “Exchanges” are now down to one carrier. Obamacare seems finished.
Repealing Obamacare probably needs to be done with some conservative regard for the status quo. It won’t be acceptable to just go back to what we had. Policies are in effect. Insurance companies are relying upon the existing law. Consumers and voters want to preserve the ability to purchase insurance even with a pre-existing condition. And yes, it can be done. That part of President Obama’s legacy will survive.
Donald J. Trump won my vote promising a nationwide market, and competition and getting rid of the mandate. Trump must demand the repeal of Obamacare and a replacement, a great replacement, the best replacement, and If Congress fails, Congress had better not fail. You don’t want to have to read those tweets.
Don’t believe your local health insurance employee or board member who says a nationwide market can’t be done. Yes. We. Can. With one nationwide or “all states” market, insurance companies would be competing for an enormous flow of premiums.
Don’t be surprised if millennials were adding affordable health insurance to their two year cell phone agreements by 2018, or have it linked to their first credit card, or new automobile purchase, or their apartment, or ho hum, their employer loves the lower cost created in a better marketplace. Huge opportunities create huge investment and extraordinary innovation. We’ve seen what can happen when the government fosters commerce by creating and defining one great big opportunity. Imagine if health insurance reform actually spurred economic growth? Granted, a better marketplace may not cure all, but it needs to be tried.
Expect medical savings accounts (HSA/MSA’s) like IRA’s to be part of the reform. But repeal of the mandate must be part of the reform. A compulsory purchase does not allow consumers to regulate costs in any way. It’s no surprise Obamacare could not make insurance affordable and simply transferred costs from some subscribers to other subscribers working hard to pay for it all. The mandate, and the state sized monopoly markets have to go. Trump’s first 100 days will be measured not by the low hanging fruit of “wrestling” tax cuts rather, President-Elect Trump will be measured by whether or not he delivers a great healthcare reform that truly leads to affordable health insurance and saves us from that grim sounding rusty future where 20% of all dollars spent in the U.S. are spent on healthcare. We don’t work for health insurance. We work for ourselves and our families.
Michael J. Gardiner is an attorney residing in Providence. He was a Republican candidate for office in 2010 and 2012.
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