Former President Donald Trump
President Donald Trump is continuing to signal that he is interested in providing cash that people can use to buy their own health coverage, rather than sending subsidy money to health insurers through the current Affordable Care Act premium subsidy tax credit system.
Trump talked about the federal cash-for-coverage idea Monday on a Fox News talk show hosted by Laura Ingraham.
When Ingraham asked him about how he'd replace the current ACA "Obamacare" subsidy system for individual major medical insurance, he said he wants "money to go into an account for people, where the people buy their own health insurance."
"It's so good," Trump said. "The insurance will be better. It'll cost less. Everyone's going to be happy."
Trump appeared to be talking about the idea he discussed Saturday, in a Truth Social post, about the idea that federal health insurance subsidy money should go straight to consumers, rather than to "money sucking Insurance Companies."
The backdrop: Some Republicans in Congress have talked about replacing some or all of the current ACA premium subsidy system with health coverage purchasing cash accounts that might resemble health savings accounts.
They and analysts who are popular with Republicans say the current ACA rules make individual major medical coverage too rich and too expensive for ordinary people.
Other Republicans have talked about wanting to extend the current, relatively high level of subsidies created in response to the COVID-19 pandemic until Republicans have developed a modified version of the current subsidy system.
Republican subsidy extension supporters say they want to make sure the new system will help people keep their current health coverage and protect the ability of people who are obese or who have cancer to buy coverage without worries about medical underwriting.
Health insurance actuaries and others have argued that poorly designed efforts to simplify ACA subsidies rules could kill parts of the health insurance market, by causing older, sicker people to flock to certain coverage issuers and swamp those issuers with huge medical claims.
What Trump's remarks mean for employer health benefits: Trump's Truth Social post and interview remarks suggest that he's listening to the advocates of a shift to a cash-for-coverage approach, rather than to advocates for efforts to shore up the current system.
If the country returns to something like the health coverage rules in effect before 2010, when the two bills that created the Affordable Care Act were signed, that could increase overall claim costs for employers that keep coverage in place, by increasing the number of people without health coverage and leading doctors and hospitals to get more revenue from patients with commercial coverage.
But, if the cash-for-coverage strategy comes with a broad return to pre-ACA rules, that could also reduce employers' coverage costs, by eliminating many of the current coverage mandates and making it easier for employers to cut or eliminate coverage for services such as checkups, maternity care and behavioral health care.
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