For the November election, we recently outlined the health care proposals of former Secretary of State Hillary Clinton, focusing on how those proposals might affect the price of insulin. In this post, we’re going to do the same with businessman Donald Trump.
To do this, we have to remove a lot of hypotheticals about this polarizing candidate, including how the overall economy might fare under a Trump administration, and focus specifically on just his official position on health care policy and what he has said directly about drug pricing.
First, it should be noted that Trump, like many Republicans, favors repealing the Affordable Care Act, also known as Obamacare. Unlike many other Republican candidates, however, he has said that he still would call for health insurance companies to provide coverage regardless of preexisting conditions, a key component of Obamacare. While most would agree that many health insurance plans don’t pay for enough of the out-of-pocket costs of insulin, those out-of-pocket costs would most likely be even greater if insurance companies refused to cover people with diabetes.
Trump also advocated earlier this year for empowering Medicare to negotiate with drug companies to lower drug prices. This position is not new, but is more often proposed by Democrats. There has been a long-simmering debate about whether such a move would yield savings, and, if so, what size of savings. However, such a move would require Congress to work with Trump to pass new legislation authorizing Medicare to negotiate, and congressional Republicans signaled earlier this year that they weren’t willing to consider such a move. If this stance still held true in 2017, then the only hope for Trump to get this reform enacted would be to enlist Democrats to help pass it. In either case, Trump seems to have quietly backed off from this proposal, and it does not appear in the current position paper on health care reform.
Trump’s position paper states that his administration would work to remove barriers that hamper the importation of cheaper drugs that are made abroad. This is a populist stance that also has been favored by Hillary Clinton, Bernie Sanders, and other liberals. To make this work, the FDA would have to be expanded to have the capacity to investigate foreign drug-making facilities more than it already does. This idea also would require Congressional approval, and that would again most likely require Democrats to side with Trump to pass. In both cases, Trump has won few friends among Democratic lawmakers, and it would be interesting to see if that animosity would be put aside to pass reforms both sides want.
Of course, this policy discussion comes with one large caveat – a Donald Trump victory on November 8th most likely would signal a realignment of the Republican Party to be more populist in its positions, and that would create a realignment of the two political parties. In other words, if Trump wins, all bets of what might happen may be off.
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