Trump’s health care plan: What he promises and what it really says

Donald Trump needs to flesh out his economic plan

On the campaign trail, Donald Trump proudly said he supports health care policies that Republicans don’t usually embrace.

Over the past few months, he said he wants to protect people with pre-existing conditions and likes the individual mandate requiring everyone to get health insurance. He also said he supports letting Medicare negotiate drug prices and wants to prevent people from dying in the street.

But the seven-point health care plan released by the GOP frontrunner on Wednesday largely looks like it was taken straight out of a Republican playbook. Citing the importance of bringing “free market reforms” to the health care industry, Trump would repeal Obamacare, boost competition by allowing insurers to sell policies in other states, broaden Health Savings Accounts and turn Medicaid into a block grant to be run by the states.

And even though he has said that Congress is in the back pocket of the insurers, Trump’s plan would also put the onus of reform on lawmakers, saying that any changes must start with them. None of his other policy positions punt to Capitol Hill.

Related: Donald Trump releases health care reform plan

Here’s how his plan differs from what he’s said during the campaign:

Universal health care

In CNN’s town hall last month, Trump said he likes the Obamacare mandate that requires every American to be insured. He went even further in a 60 Minutes interview last fall.

“Everybody’s got to be covered. This is an un-Republican thing for me to say…,” he told Scott Pelley. “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”

But in his plan, he says: “Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.”

Related: Trump: Obamacare is a disaster

Pre-existing conditions

At CNN’s GOP debate last month, Trump said he would get rid of Obamacare but maintain the provision that insurers must cover people with pre-existing conditions.

“I want to keep pre-existing conditions. I think we need it. I think it’s a modern age. And I think we have to have it,” he told Dana Bash.

His plan, however, offers no defense of those with pre-existing conditions. Instead, he said Obamacare must be repealed “completely.”

Allowing Medicare to negotiate drug prices

Trump told a New Hampshire crowd in January that Medicare should be allowed to negotiate drug prices because it could save $300 billion a year, according to the Associated Press. This is something Democrats have wanted to do for years, but Republicans have always opposed it.

What he actually proposes, however, is allowing Americans to buy drugs from overseas.

Related: Why pharmaceuticals are cheaper abroad

Not letting people ‘die in the streets’

Trump is most emphatic when talking about having the government take care of poor people who are sick.

“You cannot let people die on the street, ok? Now, some people would say, “that’s not a very Republican thing to say.” Every time I say this at a rally…it got a standing ovation,” he said at a CNN town hall last month. “The problem is that everybody thinks that you people, as Republicans, hate the concept of taking care of people that are really, really sick and are gonna die. We gotta take care of people that can’t take care of themselves.”

On the trail, Trump has sketched different ways of accomplishing this. He’s mentioned making deals with hospitals and “concepts of Medicare.”

But in his plan, he only says that no one should slip through the cracks because they can’t afford coverage. While he wants to repeal Obamacare’s Medicaid expansion provision, he says it could be accomplished by reviewing “basic options for Medicaid” and working with states to ensure health care is provided to those who want it.

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