Donald Trump’s significant gift to economic prosperity was deregulation, especially in the health care sector. Joe Biden, on the other hand, has been re-regulating the economy, leading to a stark contrast in approaches to health care. Trump’s deregulation efforts included vaccine production, which prepared the country for Covid-19. This early action saved an estimated 183,000 lives and produced vaccines six months earlier than expected.
Under the Obamacare exchanges, families faced high premiums and deductibles, leading to tens of thousands of dollars in expenses before receiving any benefits. In response, Democrats created enhanced subsidies, giving free health insurance to average-income families. However, for those with chronic conditions, out-of-pocket costs remained high. Trump’s executive order expanded options, allowing the purchase of short-term insurance with lower costs and better coverage.
Employers were previously allowed to fund individually owned health insurance pre-Obamacare, but Obama shut down this practice. Trump’s rule reinstated this option in 2020, leading to a revival of personal and portable health insurance for employees. Congressional action is needed to fully take advantage of these opportunities and expand insurance options further, including short-term plans.
Telemedicine was liberated under the Trump administration, allowing doctors to bill Medicare for virtual consultations. This move was crucial during the Covid crisis and was made possible by the administration’s belief in deregulating telehealth barriers. Patients with chronic illnesses also benefited from Trump’s policies, with guidance allowing employers and insurers to provide coverage for maintenance drugs without affecting HSAs.
Trump’s administration encouraged focused factories in Medicare, specialized in chronic conditions, improving care quality. The move towards round-the-clock primary care through direct primary care (DPC) also made primary care more accessible and affordable. The goal of allowing employers to fund individual accounts for DPC payments remains unfulfilled and could be a priority in a second Trump term. Trump’s vision for health care reform focuses on choice and competition, arguing that government failure, not market failure, is the root of issues in the healthcare system. Completing the agenda of the first Trump administration could lead to further reforms in health care.
