Donald Trump doesn't have much in the way of a healthcare reform plan, which proves he really is a Republican, but what he does have would be a disaster for the all the people who gained coverage under Obamacare. That's the conclusion from a study by the RAND Corporation, a global research organization, and the Commonwealth Fund in a computer simulation that mapped out the potential effects of both Trump's and Hillary Clinton's healthcare proposals. Trump would dump 20 million people, Clinton would provide coverage for 9 million over Obamacare's achievement.
The study estimated that Trump's repeal of "Obamacare" would increase the number of uninsured people from 24.9 million to 44.6 million in 2018. But then his replacement proposals would have a push-pull effect. The tax deduction and interstate health insurance sales would help some stay covered, but the Medicaid block grant would make even more people uninsured.
"The people who would actually gain coverage tend to have higher incomes," said Collins.
The result would be an estimated 45.1 million uninsured people in 2018 under Trump — an increase of 20.2 million, reversing the coverage gains under Obama.
The Clinton proposals analyzed included a new tax credit for deductibles and copayments not covered by insurance, a richer formula for health law subsidies, a fix for the law's "family glitch" that can deny subsidies to some dependents, and a new government-sponsored "public option" health plan.
The estimates for coverage gain under Clinton's plan don't include her idea for Medicare buy-in by middle-aged adults, or her proposals for getting more states to expand Medicaid, so the gain of 9.1 million people she would extend coverage to is conservative. And it doesn't really show how bad Trump's "plan" could be for everyone, because he insists the uninsured will still get care—which means we go back to those costs being shifted to state and federal taxpayers.
There really is no comparison here. One candidate wants to go back to the bad old days and try to erase everything Obamacare has achieved, one wants to build on its successes.
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