In his first press conference since July 2016, President-elect Donald Trump confirmed he favored an “essentially simultaneous” repeal-and-replace of the Affordable Care Act (ACA) and said his nominee to take over HHS, U.S. Rep. Tom Price, MD, R-Georgia, will be introducing details of the plan after he’s confirmed.
When asked about what timeline he favored for getting rid of the ACA, Trump first attacked the law as a “complete and total disaster.” He referenced the increased premiums for coverage on the ACA marketplaces in 2017 and stated some states had increases of more than 100 percent. The average hike was 22 percent nationwide, with only one state, Arizona, seeing a rise in the triple digits, at 145 percent.
He went to say replacing the ACA is a favor to Democrats.
“They own it right now,” Trump said. “So the easiest thing would be to let it implode and seventeen and, leave me, we'd get pretty much whatever he wanted. But it would take a long time. We're going to be submitting, as soon as our secretary is approved, almost simultaneously—shortly thereafter—a plan. It will be repeal and replace. It will be, essentially, simultaneous.”
The president-elect didn’t respond to the second part of the question, asking whether the replacement would guarantee coverage for those who have been insured through ACA provisions, like the marketplaces or Medicaid expansion.
Trump didn’t offer specifics on the replacement plan, promising it would be less expensive and "far better” than high-deductible marketplace plans. He did say the details would be fleshed out after Price’s confirmation hearing, which is scheduled for Jan. 18.
Older ACA alternatives may offer some clues as to what the Price-Trump plan could look like. Price, an orthopedic surgeon, has proposed a replacement plan called the Empowering Patients First Act, which included fixed tax credits, not tied to income, for people to buy insurance, would’ve excluded patients with pre-existing conditions from immediate coverage if they hadn’t been insured for the prior 18 months, and created state-run high-risk pools for those deemed too expensive to cover by private insurers.
Several of Price and Trump's healthcare proposals were harshly criticized by current HHS Secretary Sylvia Burwell in a Jan. 9 speech. She warned the idea of keeping the ban on insurers denying coverage for pre-existing conditions while eliminating the ACA's individual mandate to buy insurance would result in sharply increased premiums.
Trump also touched on the pharmaceutical industry in the opening remarks of his press conference, suggesting his administration would favor allowing Medicare to negotiate drug prices.
“Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there's very little bidding on drugs. We’re the largest buyer of drugs in the world, and yet we don't bid properly. And were going to start bidding and were going to save billions of dollars over a period of time,” he said.
The remarks led to pharmaceutical and biotechnology stocks fall as much as 2.7 percent before his press conference ended, according to Bloomberg.