I've taken the liberty of striking-through the bullshit fluff to make it easier to focus on the real proposals contained herein, along with my (mostly) cited opinion of it.


Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate1true | and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs2false, websites that don’t work3true, greater rationing of care4unknown/false, higher premiums5false, less competition and fewer choices6false. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to [we] bring much-needed free market reforms to the healthcare industry7what?.

But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.

However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.

Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.

Congress must act. Our elected representatives in the House and Senate must:

Completely repeal Obamacare8why?. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to9false.
Modify existing law that inhibits the sale of health insurance across state lines10good idea. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state11good idea. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up12mm false.

Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system13agreed. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid14agreed and work with states to ensure that those who want healthcare coverage can have it.
Allow individuals to use Health Savings Accounts (HSAs)15. Contributions into HSAs should be tax-free and should be allowed to accumulate16maybe. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty17maybe. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans18maybe. These funds can be used by any member of a family without penalty19cool!. The flexibility and security provided by HSAs will be of great benefit to all who participate20maybe.
Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals21YES!. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure22YES!.
Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure23dunno. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead24false. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources25what fraud?.
Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products26agreed. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers27agreed.
The reforms outlined above will lower healthcare costs for all Americans28mmm I dunno. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws29what?, eliminating fraud and waste30what fraud? and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation.

Providing healthcare to illegal immigrants costs us some $11 billion annually31hmm. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments32let's see the data.

To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.

Finally, we need to reform our mental health programs and institutions 33go on... in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.

To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country. These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again.

  1. True; The Patient Protection and Affordable care Act was passed solely by democrats. https://www.govtrack.us/congress/votes/111-2010/h165

  2. Completely false. The problem of faster-than-GDP-growth healthcare costs is one that has existed for 30 years. We have an aging population and we've tried fee-for-service + mixed public/private payor system for 30+ years that is not a viable model going into the future. Oh and what's going on with the chart at the end there?

  3. True; the Obama administration botched the fuck out of the roll-out of National Healthcare Exchange. As did former Lt. Governor Anthony Brown's team did with the exchange in Maryland. Real shame here; lots of waste in tax-payer money b/c these folks didn't hire and manage the right people, to hire and manage the right companies to get this done.

  4. Unknown. We should also define "rationed care." Given that 17-23 million new people have health insurance (http://www.forbes.com/sites/scottgottlieb/2015/05/14/how-many-people-has-obamacare-really-insured/#38c632c777f0) it might follow that there's a short-term increase in rationing until supply of healthcare professionals can meet the increased demand for services.

  5. False; Obamacare didn't cause rising premiums, like the previous chart shows, it's a problem that's been happening for decades.

  6. False; Let's get something straight: State-run Healthcare Exchanges increased competition among health insurers. (https://www.washingtonpost.com/national/health-science/hhs-increased-competition-on-insurance-exchanges-restrained-premiums/2015/07/30/81596920-36bf-11e5-9739-170df8af8eb9_story.html.) Admittedly the restrictions of state-borders on coverage is something that needs to be addressed (and something Mr. Trump mentions below,) but the the assertion that Obamacare has decreased competition in the healthcare free market is outright wrong.

  7. This is more of a pet peeve, but what do "free market reforms" mean exactly here in this context? We have the most privatized healthcare industry in the developed world as is, so which "reforms" are we talking about here?

  8. Something something baby bathwater. This is stupid, hyperbolic rhetoric. Unless you list out the all of the contents of the ACAPPA bill(s), why you disagree with them, and your proposed alternatives. If you're going to complain, at least be specific.

  9. The Supreme Court upheld the individual mandate, and there's an economic reason behind it too: demand for healthcare services is complex, irrational, multivariate and changes over time, ultimately leading to solidly inelastic demand at the end of our lives. If young people only pay for what they need, many (if not most) people will not have enough in their 70s-80s-90s (remember why Social Security became a thing.)

  10. Agreed. Health insurance options/contents should be more standardized across states, so that the best integrative care networks (Mayo, Kaiser, Intermountain Health) can expand and bring their models to other regions.

  11. As long as the plan meets certain requirements to cover the economic arrangement I discussed in #9.

  12. Unknown. What is known is that single-payor systems in western Europe & Canada work pretty damn well. There are waits, but there's a private market for care if you have the money to buy it, and a universal system for everything else. If Mr. Trump wants to make this claim, he's got to provide data, research, or case studies. Because we've got several nation-states worth of argument in our nationalized healthcare favor.

  13. I like this, this would be nice. And we need to encourage people to save for healthcare in their retirement as a necessary expense.

  14. Mr. Trump is treading lightly here so as not to unsettle the AARP, but he's right: we've got to reign in medicare spending for the baby boomer generation somehow.

  15. I'm fine with this as long as we have some economists and actuaries crank out what the bare minimum plans have in order to satisfy the economic discussion in point #9 above.

  16. Sounds good.

  17. Also sounds good.

  18. I'm fine with this as long as we have some economists and actuaries crank out what the bare minimum plans have in order to satisfy the economic discussion in point #9 above.

  19. Rock.

  20. As long as we have some economists and actuaries crank out what the bare minimum plans have in order to satisfy the economic discussion in point #9 above.

  21. Yes!!! We need cost transparency in healthcare, for everyone involved. There is research that suggests cost influences physician behavior and several startups, cough cough ahem, have tried to tackle this problem. You know how we solve it? FEDERAL LEGISLATURE WHAT'S UP. ALSO A UNIVERSAL MEDICAL RECORD ID NUMBER WHILE YOU'RE AT IT PLS THX.

  22. Yep, companies are trying to solve this right now. It goes against existing establishments and is going to be a painful transition. But we've got to get it done. With federal mandates.

  23. I'm not familiar with the block-grant proposal, so I can't comment here. #TODO

  24. Wrong, medicare is not an inefficient monolithic beast that needs to be gutted. It works quite well, and given it's budget more effectively than it's private industry counterparts (http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/.) We need to be talking about the option of Medicare Part E: Everyone.

  25. The states tried to act as incubators and solve this, but they failed. Healthcare costs are increasing too fast to try this approach. We need to combine efforts at a federal level.

  26. Agreed. Big pharma is productive and we thank them, but we need to figure out a way to balance public goods and profit motive, especially for off-patent medications.

  27. Agreed, pharmaceutical trade agreements need to bring cheaper drugs to the U.S. The costs for off-patent meds needs to come down.

  28. Some of these reforms, maybe. Other reforms would most definitely dramatically increase healthcare costs for Americans. <-- See how easy it is to say such things. Your evidence first, please, Mr. Trump.

  29. I could not find quality sources backing the described economic burden of illegal immigrant healthcare services. Maybe Mr. Trump could provide some and we could have a real discussion about options and policy.

  30. As discussed above in point #23, Medicare is very efficient with very little fraud. Numbers and research into these claims would go a long way here.

  31. I could not find quality sources backing the described economic burden of illegal immigrant healthcare services. Maybe Mr. Trump could provide some and we could have a real discussion about options and policy.

  32. Again, I could not find quality sources backing the described economic burden of illegal immigrant healthcare services. Maybe Mr. Trump could provide some and we could have a real discussion about options and policy.

  33. Agreed. But he offered no suggestions or observations about the current systems, so I'm not really sure why his writers included this statement. I have a couple of my own to be outlined in a future post.