‘Absolutely no detail’: experts alarmed as Trump unveils healthcare plan

Still stuck on concepts of a plan, then?


Dangit, Reddit’s broke, I’m getting stories from 10 years ago…

Some gems from Whitehouse.gov:

“Your prescription drugs will come way, way down and, under this policy, the prices of many drugs will be slashed by 300, 400 even 500% starting this month at the Trumprx.gov.”

“The government is going to pay the money directly to you. It goes to you, and then you take the money and buy your own healthcare… the big insurance companies lose and the people of our country win.”

“I want to end this flagrant scam and put extra money straight into the healthcare savings account in your name, and you go out and buy your own healthcare, and you’ll make a great deal, you’ll get better healthcare for less money—that way you can choose the care that is right for your family.”

Still only the vaguest explanation on how this is supposed to work, where the money is going to come from for these government sponsored HSAs (how is this any different than ACA subsidies?), let alone slashing the price of drugs by… 500%!

Here’s the key difference MAGA keep missing:

**The Affordable Care Act is a functioning system.
This White House document is a list of slogans.**

They are not even operating at the same level.

—

## How the ACA actually works

The ACA is not one idea. It is a **multi-layered regulatory and financing framework** designed to stabilize insurance markets while expanding coverage.

It does several hard things at once:

### 1. It creates a regulated insurance market
– Guaranteed issue: insurers must cover people regardless of pre-existing conditions
– Community rating: limits how much insurers can vary premiums by age
– Essential Health Benefits: minimum coverage standards so plans cannot quietly become junk

This is the foundation. Without it, the rest collapses.

—

### 2. It stabilizes risk pools
The ACA explicitly addresses adverse selection.

It does this through:
– Subsidies tied to income
– Cost-sharing reductions
– Market rules that discourage cherry-picking healthy people
– Risk adjustment among insurers

This is boring, technical, and absolutely necessary. Insurance markets fail without it.

—

### 3. It uses subsidies, not vouchers
ACA subsidies are:
– Income-based
– Tied to benchmark plans
– Automatically adjusted
– Designed to scale with medical inflation

This matters because healthcare costs are not static. Vouchers are.

—

### 4. It integrates with existing systems
The ACA does not pretend Medicare, Medicaid, and employer insurance do not exist.

Instead it:
– Expands Medicaid where states allow
– Preserves employer-sponsored insurance
– Coordinates eligibility across programs
– Uses federal enforcement through HHS and CMS

This is why it actually functions nationally.

—

### 5. It is enforceable law
The ACA is:
– Thousands of pages of statute and regulation
– Backed by budgets
– Enforced by agencies
– Litigated, stress-tested, and amended over 15 years

It survives because it is built to survive.

—

## What the White House document does instead

Now compare that to what this document offers.

—

### 1. No market structure
There is:
– No guaranteed issue framework
– No explanation of pre-existing conditions
– No definition of minimum coverage
– No mechanism to prevent insurers from dumping sick patients

You cannot say “choice” and skip market rules. That is how pre-ACA markets failed.

—

### 2. Vouchers without guardrails
“Send the money directly to the people” is a voucher system.

What is missing:
– How voucher amounts are calculated
– Whether they adjust for age or illness
– How they keep premiums from rising faster than vouchers
– How risk pools remain viable

This is the exact problem the ACA was designed to solve.

—

### 3. No risk management at all
The document does not mention:
– Adverse selection
– Risk adjustment
– Reinsurance
– Enrollment stability

This omission alone disqualifies it as a serious proposal.

—

### 4. Transparency without enforcement
The ACA already tried transparency.
It paired it with:
– Medical loss ratio rules
– Rate review
– Federal enforcement authority

This document:
– Demands disclosures
– Provides no enforcement
– Ignores how insurers game transparency rules

Posting numbers does not change incentives.

—

### 5. Drug pricing without legal reality
The ACA uses:
– Statutory authority
– CMS rulemaking
– Negotiation within defined programs

This document:
– Repeats MFN talking points
– Ignores prior court failures
– Explains nothing about implementation scope

Wishing prices lower is not policy.

—

## The core difference

The ACA answers hard questions:
– Who pays?
– Who enforces?
– Who is protected?
– What happens when things go wrong?

This document avoids those questions entirely.

—

## Bottom line

The ACA is flawed, complex, and imperfect.

But it is:
– Structured
– Enforceable
– Integrated
– Designed to survive reality

This White House document is:
– Aspirational
– Vague
– Non-operational
– Structurally incomplete

They are not alternatives.

One is governance.
The other is messaging.

>…titled the Great Healthcare Plan

Ah, that’s the problem, they didn’t let him add TRUMP anywhere in the name.

Alarmed? Who expected anything more than concepts of a plan?

It’s all bullshit from him. Everything he says and his regime

Because there is no plan

Written in sharpie on the back of a Big Mac wrapper.