Donald Trump’s proposed health care policies have been largely vague, but the few specifics he has offered have led at least one expert to conclude that millions would lose coverage if the bombastic billionaire got his way as president.

The study from the nonpartisan Center for Health and Economy found that 18 million would lose coverage, and premiums in the individual insurance market would likely decline as well.

Much of the loss in coverage would come from Trump’s plan to turn Medicaid into a block grant program, which would likely deal a big blow to the millions who have gained Medicaid coverage as part of the Affordable Care Act’s expansion of the low-income health insurance program.

Trump’s support for turning Medicaid into a block grant is one of the few concrete areas of agreement he has had with House Speaker Paul Ryan, R-Wis., on reining in social welfare programs.

Trump has been steadfast in his support for maintaining Medicare and Social Security as they currently exist, in contrast to Ryan, who has proposed reforming the programs by raising the age of eligibility for benefits and by partially privatizing the programs.

The insured rate would also drop because Trump’s plan would eliminate the individual mandate to purchase insurance. And although Trump has promised that his plan would provide universal coverage, regardless of preexisting conditions, the study found no evidence of such a guarantee in the plan that Trump has released.

"You are going to get a lot thinner coverage both in terms of higher deductibles and fewer benefits," John Holahan of the Urban Institute think tank told Yahoo News. "The policy is bad for people with high risk, and good for people with low risk."

The repeal of the ACA, as well as the associated rules imposed on the insurance industry by the Obama administration in recent years, would allow insurance companies to sell plans that fall well short of what is commonly accepted as comprehensive medical insurance.

Insurers already won a victory on that front last week, when a federal court struck down an Obama administration rule that prohibited insurers from selling “fixed indemnity” plans as stand-alone policies. 

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