Where GOP presidential nominee Trump aligns with his party on health care

Topics: Politics and Policy, Elections, 2016, Health Care Reform

By Josh Zeitlin, contributing editor

The delegates at the Republican National Convention on Tuesday officially nominated Donald Trump for president.

But even though Trump is now the party's formal leader, his health care policy agenda doesn't always align with the views of other top Republicans.

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Trump backs some cherished Republican health care ideas, such as repealing the Affordable Care Act (ACA). But he also has endorsed proposals that divide the Republican Party, such as prescription drug importation—and has even gestured toward ideas he calls "un-Republican."

Where Trump and GOP lawmakers align

On the ACA, Trump is in lockstep with most of his party: He supports fully repealing the law, which he has called a "disaster."

Trump's seven-point health care plan, titled "Healthcare Reform to Make America Great Again," also largely aligns with other Republican proposals.

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Like GOP lawmakers, Trump wants to reduce barriers to selling insurance across state lines, expand the ability of Americans to use tax-deductible Health Savings Accounts (HSAs) to cover out-of-pocket health care costs, and turn Medicaid into a block grant program.

Trump also says he would "require price transparency from all health care providers," a policy that has been backed by some GOP governors and lawmakers, including Florida Gov. Rick Scott.

Where Trump and GOP lawmakers disagree

But Trump splits with some members of his party on policies related to drug costs.

For instance, Trump in his plan calls for the United States to allow importation of prescription drugs from other countries as a way to increase competition and drive down costs. That's a policy that has divided both parties: 16 Senate Republicans voted in favor of a 2012 amendment to allow the importation of drugs from Canada, 29 voted against it, and Democrats were essentially split.

In addition, Trump on the campaign trail has touted a proposal to allow Medicare to negotiate drug prices directly with pharmaceutical companies—a policy GOP lawmakers have blocked for more than a decade.

Uncertainty about some health policy areas

In other aspects of health care policy, it appears from Trump's previous comments that he might disagree with most GOP officials, but his formal health plan doesn't provide much clarity.

For example, the GOP's official party platform, approved by convention delegates Tuesday, would give U.S. residents under the age of 55 "the option of traditional Medicare or transition[ing] to a premium-support model" that would give beneficiaries "an income-adjusted contribution toward a plan of their choice, with catastrophic protection."

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However, Trump in a tweet posted last year claimed he was "the first [and] only potential GOP candidate Trump in a tweet posted last year claimed he was "the first [and] only potential GOP candidate to state there will be no cuts to Social Security, Medicare, [and] Medicaid." Trump in May said that he would keep Medicare "the way it is" if elected.

Yet the campaign's chief policy advisor Sam Clovis that same month said at an event in Washington, D.C., that a Trump administration eventually would "start to take a look at all [government] programs, including entitlement programs like Social Security and Medicare." Clovis argued that such an examination is necessary because "the budgetary discipline that we've shown over the last 84 years has been horrible."

Meanwhile, Trump has also voiced support for universal health care, although his formal health plan does not provide details on how he would achieve it.

"Everybody's got to be covered," he told CBS' "60 Minutes" in September. "This is an un-Republican thing for me to say," Trump noted—but he added, "I don't care if it costs me votes or not."

In addition, Trump said he "would make a deal with existing hospitals to take care" of low-income people who otherwise could not afford coverage. He said that the "government's gonna pay for it," but that it would "save so much money on the other side."

Much could depend on congressional elections

Ultimately, how much a Trump administration could change health care will depend on the results of congressional elections. In particular, it remains to be seen whether Republicans or Democrats will control the Senate next year.

It's also unclear to what extent Trump might push his own health policy agenda as president, or whether he might let GOP lawmakers take the lead.