Trump's Healthcare Plan Is Just a Mirage

"There was an enormous hullabaloo in Washington over the weekend when reports surfaced that Donald Trump was about to unveil a health-care deal without much in the way of advance consultation with his congressional Republican vassals. According to multiple accounts, the plan would include a two-year extension of the enhanced Obamacare premium subsidies due to expire at the end of the year with new (and fairly minor) eligibility limits and a "skin in the game" requirement of minimum premium payments. There would have also been some sort of Health Savings Account option in a gesture to conservatives who want to get rid of health insurance and encourage people to pay health-care providers directly. But by and large, the proposal as presented was very much along the lines of what was being discussed behind the scenes by both Republican and Democratic senators and was politically feasible, recognizing that some lawmakers in both parties won't support any deal at all."

"But Monday came and went without the expected presidential announcement, and next thing you knew Trump was headed to Mar-a-Lago for Thanksgiving. It's possible that the rollout of what would have inevitably been labeled "Trumpcare" was simply delayed until next week. But all along, the prospects of a presidentially brokered health-care deal depended on speed, stealth, and a my-way-or-the-highway declaration from Trump that his plan had to be backed by virtually every congressional Republican, much like his One Big Beautiful Bill Act. It sure looked like that sort of Trump blitz was in the works, until it wasn't."

Reports described a Trump initiative to unveil a health-care deal that would extend enhanced Affordable Care Act premium subsidies for two years, add modest eligibility limits, require minimum premium payments, and offer a Health Savings Account option favored by some conservatives. The proposal closely resembled bipartisan Senate discussions and was presented as politically feasible while acknowledging likely dissent within both parties. The expected presidential announcement did not occur before Thanksgiving, and the plan’s success depended on a rapid, top-down White House push. House Speaker Mike Johnson cautioned the White House that most House Republicans oppose extending enhanced subsidies, complicating Congressional approval.

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