Tiana Clewis: Tell me, what do you know about the America First Healthcare Plan?
Nearly two weeks ago, President Trump laid out his healthcare policy, a policy that we've really been waiting on for like four years. And the question on everyone's mind is, was it worth the wait?
Now, you know me, I do my best to keep politics out of the podcast and off my channel, but when I remembered that two-thirds of families filing for bankruptcy site medical bills as a key contributing factor, I knew that I definitely had to say something. So once again, I headed over to the White House website, downloaded a copy of the order and started reading.
And if I can be honest with you, I was a little surprised at what I actually found there.
So today I'm going to break down everything that I found in the America First Healthcare Plan - the good, the bad, and the ugly - and how I think it's going to impact your bank accounts.
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Okay. Let's get to this executive order.
I have to admit, with the way that the President hyped up his order in the press conference, I thought he was about to push out some sweeping changes, but what I actually saw was something very, very different.
So if you read through the order, you'll see that it's basically broken down into two primary sections. Now, yes, technically there are six sections, but when I read through the order, I ended up lumping sections two through six together. And when I talk about it in a moment, you'll see why.
So I view this order as having two main sections and both of those sections have three major theme. The first theme is restoring choice to Americans for insurance and medical care options. The second is lowering healthcare costs for Americans, including drug costs. And three providing better quality healthcare for Americans and all patients in the U.S.
From the sense of a healthcare plan, those themes make a lot of sense, and all of them have an impact on your finances. For example, poor quality medical care usually results in patients revisiting the doctors and hospitals over and over again, which costs more money. So if this plan does what it says, it can be very, very, very beneficial to all of our pockets.
So since the two primary sections have the exact same three subsections, what's the difference between the two?
In essence, the first section talks about executive orders and healthcare laws that have already been passed by the Trump administration. It almost feels like they're attempting to make a case for how hard they've been working in the area of healthcare, as this section spends a lot of time pointing to data saying how the previous actions have, or will in the future improve healthcare and healthcare costs for Americans.
On my printed copy of the order, this section took up 9 of the 12 pages.
The second section provides instruction on a future actions that should be taken and this is where I found myself getting a little frustrated because it was deja vu all over again. If you watched the video that I did back in August, breaking down President Trump's executive orders on coronavirus relief, you'll know that I was a bit frustrated by them because they didn't lay out an actual plan.
Well, I'm having the exact same problem here.
To show you what I mean, we're going to do the same thing we did last time: walk through each of the actions being ordered in this plan.
So the second part of the order starts at the section two, which says:
"Policy. It has been and will contain to be the policy of the United States to give Americans seeking healthcare, more choice, lower costs, and better care, and to ensure that Americans with preexisting conditions can obtain the insurance of their choice at affordable rates."
So in this section, you can see the three themes here: more choice, lower healthcare costs and better quality care. You also see the inclusion of preexisting conditions, which has been a hot button issue.
Now I'm blessed in that my preexisting condition, asthma, has never been a negative... has never had a negative impact on my insurability because it's so minor that it's more of an annoyance than an actual risk to my health. But I know people with diabetes, cancer, mental health issues, degenerative diseases, that do have to be concerned about being uninsurable or having their insurance skyrocket because of their condition.
Now, when I heard this, my ears perked up, because I knew that the Trump administration is currently in court fighting to strike down the Affordable Care Act, which is currently the only protection that those with preexisting conditions have against being denied or dropped from their insurance because of their health issues.
So their decision to bring it up had me searching for a provision in his executive order to provide protection around that very issue. Sadly, as we go through the rest of the sections, you're not going to hear anything that actually protects preexisting conditions. And frankly, that's just disappointing.
Alright, so let's shake off the disappointment and we're going to move on to section three, which says:
"Giving Americans More Choice in Healthcare. The Secretary of the Treasury, the Secretary of Labor and the Secretary of Health and Human Services shall maintain and build upon existing actions to expand access to and options for affordable healthcare."
That's it. Seriously. That's literally all that's ordered around the theme of giving Americans more choice when it comes to healthcare and insurance: "maintain and build upon existing actions to expand access to an options for affordable healthcare."
I don't know about you, but that doesn't sound like a plan.
And since there's no plan there, I'm not going to spend a bunch of time talking about it. Let's just move on to section four, which definitely has a lot more to i,. And really, it seems to be the only section with some real action behind it. So I'll read it part by part and let you be the judge.
"Section 4. Lowering Healthcare Costs for Americans. a. The Secretary of Health and Human Services in coordination with the Consumer of Food and Drugs shall maintain and build upon existing actions to expand access to affordable medicines, including accelerating the approvals of new generic and biosimilar drugs and facilitating the safe importation of affordable prescription drugs from abroad."
It's not really a plan, but I will admit that I like where it's headed. If you can get more generic drugs on the market, it brings down overall drug costs because the name brands are less able to justify to the consumer why they pay so much more for the exact same drug, because yes, generics are the exact same drug. There's no difference.
This is great for the pockets of us, regular folks who are just trying to stay sane and stay healthy.
Now let's keep reading:" b. The Secretary of the Treasury and the Secretary of Labor and the Secretary of Health and Human Services shall maintain and build upon existing actions to ensure consumers have access to meaningful price and quality information prior to the delivery of care."
"i. This is recognizing that both Chambers of the Congress have made substantial progress towards a solution to end surprise billing. The Secretary of Health and Human Services shall work with Congress to reach a legislative solution by December 31, 2020."
"ii. In the event of a legislative solution is not reached by December 31, 2020, the Secretary of Health and Human Services shall take administrative action to prevent a patient from receiving a bill for out-of-pocket expenses that the patient could not have reasonably foreseen."
"iii. Within 180 days of the date of this order, the Secretary of Health and Human Services shall update the Medicare.gov Hospital Compare website to inform beneficiaries of hospital billing quality, including:"
"a. Whether the hospital is in compliance with the Hospital Price Transparency Final Rule as amended effective January 1, 2021."
"b. Whether upon discharge the hospital provides patients with a receipt that includes a list of itemized services received during a hospital stay; and"
"c. How often the hospital pursues legal action against patients, including to garnish wages, to place a lien on a patient's home or to withdraw money from patient's income tax refund."
Now I'm going to say that this is kind of interesting because it's about the issue that many of us encounter: surprise bills from the hospital.
I think back to when my youngest son was born and we paid a certain amount in advance for all the basic services, but then there were extra bills that came along after the birth, because I got an epidural, Gabriel had to go to the NICU for a few hours, and I stayed an extra night in the hospital because I was struggling with breastfeeding and wanted to get it down before I left because breastfeeding matters.
Two months later, the medical bills for the extra star... the extra stuff coming in and while there were smaller than I'd expected thanks to Boyd's fabulous insurance at the time, not everyone has that same testimony. So I do appreciate the directives to push action that will help people make intelligent decisions on where to have their elective procedures done, but I do have concerns because of two major things.
One, in an emergency situation, no one wants to hear about cost. I remember when Trevor Noah in his book was talking about his mother being shot in South Africa. The hospital kept telling him how expensive her treatment would be and he was like, "Shut up and go fix her." So this isn't as helpful for people in those situations because they really don't care.
Two, in an emergency situation, hospitals are legally prohibited from talking to a person about billing and costs before they're triaged, which is basic... which basically means evaluated and stabilized to ensure they'll live. So if the family is there for a life threatening situation - which is really the only reason you should be in an emergency room - this transparency of billing, isn't very helpful to them either, unless the law's repealed and then you still have the first issue, so, Hmm.
Now to read the last bit.
"c. The Secretary of Health and Human Services in coordination with the Administrator of CMS shall maintain and build upon existing actions to reduce waste fraud and abuse in the healthcare system."
Now, for those who don't know, CMS is the Centers for Medicare and Medicaid Services, and if I'm honest with you, this part of the order sounds like the President is telling these folks to do what they either already were doing or already should have been doing in the first place. So while the middle of this section does have some actual action tied to it - with a set deadline for Congress and a Plan B if they fail - the rest isn't very consequential.
Let's move on to section five, which states:
"Providing Better Care to Americans. a. The Secretary of Health and Human Services and the Secretary of Veterans Affairs shall maintain and build upon existing actions to improve quality and the delivery of care for veterans."
"b. The Secretary of Health and Human Services shall continue to promote medical innovations to find novel and improve treatments for COVID-19, Alzheimer's disease, sickle cell disease, pediatric cancer, and other conditions threatening the well-being of Americans."
Once again, it sounds to me like he's really just telling the Secretary of Veterans Affairs and the Secretary of Health and Human Services to do their freaking jobs. Like, isn't the Secretary of Veteran's affairs supposed to be concerned about the quality of health care for veterans? Is that not just a standard part of their job description?
Same for the Secretary of Health and Human Services. Isn't promoting medical innovations and being concerned about the quality of medical care just a simple, basic part of the gig? I mean, I'm just saying.
The final section is a pretty standard section for all executive actions with disclaimers around the power of the order, the application of law, and that it doesn't overstep the Director of the OMB, the Office of Management and Budget, which is a group that has a surprising amount of power in Washington, but that's a whole 'nother discussion.
So overall, this America First Healthcare Plan is a bit of a disappointment because it doesn't do anything new. It relies heavily on laws and executive orders already in place, and with the exception of giving Congress a deadline on addressing surprise billing, it doesn't tell anyone to do anything that they shouldn't already be doing based on their basic job description.
So the bottom line here is that if you were expecting this executive order to have an impact on the healthcare part of your budget, you can hang that up. Really, there's just nothing to see here, folks.
That being said, if you do wish to learn about other laws and executive orders already in place that could have an impact on your finances in the future, let me know down in the comments and I'll dig more into those. Otherwise, it's time to get back to our regularly scheduled programming... at least until the next time something big happens in D.C.
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With that, you get to watching the videos and I'll see you next week. Bye bye.
On September 24, 2020, President Donald Trump stood in an airport hangar in Charlotte, North Carolina to finally unveil the healthcare plan that is supposed to replace Obamacare. From insurance to the cost of prescription drugs and the dreaded “surprise medical bill,” America has waited nearly 4 years for this health care reform. But can this health care plan really replace the Affordable Care Act? Will is really lower your hospital bills and other medical costs? Is this new health care policy worth the wait? Let’s find out!
03:32 Overview of the America First Healthcare Plan
05:46 Section 2: Policy
07:08 Section 3: Giving Americans More Choice in Healthcare
07:46 Section 4: Lowering Healthcare Costs for Americans
12:20 Section 5: Providing Better Care to Americans
13:18 Analysis of AFHP and What This Means for You
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