President Donald Trump has finally made good on his promise to let Americans in on his plans regarding health care.
Remember, it wasn’t that long ago that he slammed “Obamacare” and promised that under the Trump administration, “better Healthcare” would “be a priority.”
When a month after being reelected, Kristen Welker asked Trump for more specifics regarding his healthcare plan, he famously responded that he has “concepts of a plan.”
Almost a year later, eleven months into his administration, and forty+ days after the government was shut down over healthcare, Trump was once again asked about his healthcare plan – this time by Fox News’ Laura Ingraham.
He responded with the most detail we have gotten so far – which while not a lot, is nevertheless telling. The President focused on two elements, first the plan would be called “Trumpcare” and second, it would involve giving money to consumers and allowing them to negotiate directly with insurance companies themselves.
TRUMP: ...what I want, and probably what you’re alluding to, is the fact that I want — instead of going to the insurance companies, I want the money to go into an account for people where the people buy their own health insurance. It’s so good! The insurance will be better. It’ll cost less. Everybody’s going to be happy. They’re going to feel like entrepreneurs. They’re actually able to go out and negotiate their own insurance. And they can use it only for that reason. That’s the beauty — only for the purpose. And if we did that, that would be so exciting. Call it Trumpcare!
The idea, which he also floated on Truth Social, along with the notion of sending out $2,000 tariff “dividend” to all Americans, has been met with a good deal of skepticism, even among those from his own administration. When asked about the tariff rebate, for instance, Treasury Secretary Scott Bessent said it had not been discussed and there was no specific proposal in the works. Likewise, Kevin Hassett, Director of the National Economic Council said the president was merely “brainstorming.”
As I told Joe Mathieu on Bloomberg’s Balance of Power, ‘riffing’ or not, the idea of direct payments to Americans who then have the “freedom” to “negotiate their own insurance” is reminiscent of the early 20thCentury largely discredited legal doctrine of “liberty of contract.” In that case, conservatives argued that governments (state and federal) should not be allowed to pass regulations setting things like a minimum wage, maximum working hours, etc. because it is a violation of the Constitution’s protection of the ‘freedom to contract.’
The Supreme Court case of Lochner v NY (1905) is the most infamous example of the doctrine in action. In that case, New York set limits on the number of hours bakers could work, arguing that it was in the interest of the health, safety, and well-being of New Yorkers who, at the time, were being forced to work under harsh and often unhealthy conditions for long periods of time. When a bakery owner was fined for violating the law, he sued and the Court sided with him arguing the law violated the freedom of both the owner and his workers to negotiate their contract. In doing so, they completely ignored the inequity in the situation, not to mention the police powers of the states, and the fact that the Constitution says nothing about liberty to contract.
During the mid-late 1930s, the Court began reversing itself, allowing states to exercise their police powers in the interest of protecting the health, safety, welfare, and morals of its citizens. The first case of this type came in 1937 with West Coast v. Parrish when the Court allowed Washington state to establish a minimum wage for women (sexism of that regulation aside).
Trumpcare, at least as far as the President laid out this week, has shades of the ideology that animated the liberty to contract doctrine and the decision in Lochner to the extent that ignores the inequities between large insurance corporations and individuals. Like liberty of contract itself, it is based on the patently false idea that with a minimal payout, citizens would be in a position to negotiate against the insurance behemoths and reach a fair deal for themselves and their families.
The plan, even in its ‘conceptual phase,’ is yet another reminder of where the Trump administrations interests lie – with big corporations and interests. Just like the workers in the early 20thCentury, under this approach individuals would be left to fend for themselves. Of course, this does not even begin to address other non-starters about this ‘plan,’ including the economic realities of the idea which, as many economists have noted, would raise prices and undermine the insurance marketplaces.
