5 Healthcare Promises Trump Hasn’t Made Good on

As with all presidential candidates, Trump was full of promises back in 2016. Many Americans were frothing at the mouth over Obamacare, and Trump leveraged that contempt. He claimed that he would repeal Obamacare (also known as the Affordable Care Act) and end the country’s healthcare woes.

As we approach the next presidential election, we’ve heard a few years of big talk from Trump about making healthcare more affordable and widely available, but a lot of it has turned out to be lip service.

Here’s a closer look at five broken or unfulfilled promises.

1. Repeal Obamacare. It’s still here! Trump won big applause at campaign rallies by vowing to repeal and replace Obamacare. Some thought he might succeed in 2017, but he couldn’t get the votes in Congress to make it happen. He has been able to reshape the Affordable Care Act in some meaningful ways, but many of the basic tenets still stand. With Democrats in control of the house, it seems unlikely that the repeal will happen anytime soon.
2. No cuts to Medicaid. This was a big Trump promise intended to make Americans receiving Medicaid feel safe. (Medicaid provides health coverage to low-asset adults, children, people with disabilities, the elderly, etc.) Trump supports turning Medicaid into a block grant approach, however, which would reduce federal spending on the program over time. Many contend that this would leave states to shoulder more of the Medicaid burden, which might drive them to make cuts. He also supports imposing work requirements for Medicaid beneficiaries, which could result in fewer people receiving aid.
3. Tax deductions on health insurance premiums. Trump reasoned during his election campaign that businesses are afforded these deductions so individuals should be, too. In 2017, Trump tried to get this deduction passed through both the Republican health care bill and the tax cut bill. In the end, it didn’t make it into either one. As of this writing, there has been no change to the tax status of health insurance premiums.
4. Cut government funding to Planned Parenthood. About 40 percent of Planned Parenthood’s funding comes from the government. Trump is pro-life and has promised to defund the organization but has ultimately failed to deliver. We should say here that federal dollars don’t actually fund abortions, except in the case of rape, incest, or where a woman’s life is in danger. Critics argue, however, that even this is too much governmental support. What Trump was able to do was overturn the Obama administration’s rule that prevented states and local governments from yanking federal funding from Planned Parenthood. This move was more symbolic than actionable, but we can give him some credit for trying. Trump also tried to work the defunding measure into a couple of spending bills, but the Democratic-dominated House wasn’t having it. This initiative is stalled, and its prospects look dim.
5. Require greater transparency for healthcare fees. Trump suggested that if we could get doctors and hospitals to be more transparent about their fee schedule, people would be able to shop around. This could drive up competition and drive down healthcare costs. It sounds great in theory, but Trump has made little progress here. With the change to Obamacare, Medicare and Medicaid began requiring hospitals to list their fee schedules, but there are quite a few loopholes. For example, some hospitals only provide this information if they are specifically asked for it. Thus, healthcare fees remain obscured, which means consumers are still in the dark.

Amidst the empty promises, Trump has come through on some fronts. He succeeded in wiping out one of the least popular parts of Obamacare—the individual mandate. This required all U.S. citizens and legal residents to get health insurance or face a financial penalty from the IRS. Trump eliminated this penalty beginning in 2019. Some states have made their way around this by instituting their own individual mandate, but the federal penalty is gone.

Trump has also made a number of efforts to deliver on his campaign promise to strengthen the country’s mental health resources. His budget increases funding for a number of mental health programs as well as opioid addiction prevention and recovery programs. Critics argue that these strides could be offset by Trump’s proposed Medicaid reforms. Since many Medicaid recipients are affected by behavioral health conditions, shortchanging Medicaid in any way could deal a blow to mental health resources.

All in all, Trump’s vows to completely overhaul healthcare have fallen flat, and there’s little evidence that anything significant will change between now and the next election.

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