President-elect Donald Trump's transition website promises to "modernize Medicare" and allow more "flexibility" for Medicaid, which a health care journalist said are D.C. euphemisms for moving toward privatization of both systems.
In a 2015 interview with The Daily Signal, posted to Trump's campaign website, Trump vowed not to touch either of the government-run healthcare systems that support millions of people, most of which are poor or elderly.
“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump told The Daily Signal. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.”
But on Trump's transition website, GreatAgain.gov, Trump said he wants to maximize “flexibility for States in administering Medicaid, to enable States to experiment with innovative methods to deliver healthcare to our low-income citizens.”
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In regards to Medicare, Trump now said he wants to “modernize” the system, “so that it will be ready for the challenges with the coming retirement of the Baby Boom generation – and beyond.”
Cohn says that this type of language mirrors what Republicans like House Speaker Paul Ryan and many before him have used to push for more privatization and voucher-based systems.
“Their goal is to slash government spending on health care and to peel back regulations on parts of the health care industry, particularly insurers,” Cohn wrote.
Although there have been many Republican proposals throughout the years that have similar objectives but unclear specifics, Cohn says that it's possible to surmise what effects would take place, according to The Huffington Post.
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With Obamacare, more flexibility for insurance plans to be bought across state lines would incentivize health insurers to move to states with lesser regulations, “effectively gutting requirements more progressive states might impose on coverage.”
In effect, younger, healthier people could obtain cheaper, bare-bones coverage, but people with more health problems would pay higher costs, according to Cohn.
With Medicare, Cohn believes Trump is leaning toward Ryan's plan to create a voucher system for seniors.
Cohn admits that details of Ryan's proposal are scarce. And although Trump hasn't indicated he would follow any of Ryan's plans for healthcare, Cohn says moving toward such a system would inevitably “ratchet down the value of the vouchers over time,” leading to less health care for those who depend on Medicare.