Donald Trump Wants to Repeal Obamacare, Replace It With Obamacare


Gage Skidmore

Most of the time when Donald Trump talks about policy, the collection of words that he responds with have nothing whatsoever to do with the details of policy. Up until this weekend, for example, he usually answered questions about his preferred Obamacare replacement plan with "something terrific!"

That is, of course, not a replacement plan, nor is it any kind of plan at all. It does not even qualify as an allusion to a possible plan, or something that vaguely resembles one. It is just an adjective, and it provides no more information about the actual policy content of his ideal replacement than if he had said, "something blue!"

Occasionally, though, Trump emits noises that seem, at least on the surface, to provide at least a little more detail. 

In an interview this weekend with Scott Pelley of 60 Minutes, Trump was pressed to provide some details on how he would replace the president's health care law, which Trump has described as a "complete disaster."

Here's how the exchange went, as transcribed by Forbes' Avik Roy.

"What's your plan for Obamacare?" Pelley asked Trump. "Obamacare's going to be repealed and replaced," said Trump. "Obamacare is a disaster if you look at what's going on with premiums where they're up 40, 50, 55 percent." Pelley followed up:

Pelley: How do you fix it?

Trump: There's many different ways, by the way. Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, "No, no, the lower 25 percent that can't afford private. But–"

Pelley: Universal health care.

Trump: 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.

Pelley: The uninsured person is going to be taken care of. How? How?

Trump: They're going to be taken care of. I would make a deal with existing hospitals to take care of people. And, you know what, if this is probably—

Pelley: Make a deal? Who pays for it?

Trump: —the government's gonna pay for it. But we're going to save so much money on the other side. But for the most it's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything.

One thing this back and forth reveals is how utterly determined Trump is to avoid providing details regarding the mechanics of policy. When Pelley first asks Trump how he would fix Obamacare, Trump responds by saying, "everybody's got to be covered." That's an outcome, not a policy mechanism. It's totally unresponsive to the question of how.

Pelley, to his credit, follows up on this point, asking precisely how everyone would be covered. Trump first insists, as he often does, that he would "make a deal" (this is also not a policy) and then declares that everyone will be able to get private plans, that the government will pay for it all, and that there will be no trade offs whatsoever.

One way—perhaps the best way—to interpret this, is that it is simply nonsense. Trump clearly has no health care plan to speak of and no idea what he is talking about, so he brushes off Pelley's question with rambling, self-aggrandizing word salad that, as usual, tells us absolutely nothing about anything. It is a bunch of words that amount to, "something blue!"

Another way, however, is that what Trump is describing is, approximately, Obamacare: a system that attempts to cover the uninsured largely by giving people a choice of private plans that are heavily subsidized by the government.

Yes, Obamacare relies on Medicaid to cover many lower income people, and for various reasons doesn't cover absolutely everyone. But details like these—really, any kind of details—obviously don't matter to Trump.

What matters is that Trump, the front-runner in a part that for the last five years has been heavily defined by its opposition to the president's health care law, thinks Obamacare is such a complete disaster that he wants to repeal it and replace it with, well, Obamacare.