Trump Wants to Keep Parts of ACA: Pre-Existing Conditions and Coverage to Age 27

A major problem is that Congress mandated the medical ration between young adults and the elderly to be 1:3 instead of 1:6 which better reflects the true costs of care meaning the young would be paying 75% more than they should for their age category. Many have complained that young, healthy people are not signing up for health plans but this is the reason why. The youth are paying 75% more than they should in an efficient market. Fix the medical ratio to be 1:6 and there will probably be a lot more healthy young people signing up for insurance.<p>Much of the health care costs of the elderly are from chronic disease which itself is from smoking and obesity among other causes.<p>Other countries such as the UK, France, and Canada have tobacco taxes at least $5 to $7 per pack. The high cost of tobacco has more than half the effect to help people to quit and helps to ensure the young never start smoking. The tobacco taxes can also be used to pay for the higher health care costs that smokers have thus helping to reduce the subsidy in health care that non-smokers pays for smokers.<p>When the ACA was put into place, they should have raised the Federal tobacco tax to be $5 to $7 per pack (today it is about $1).

Anyone that looked at his campaign site would have known that he was going to keep parts of it. Instead we have scare tactic headlines all over Facebook about how he&#x27;s just going to terminate medical coverage for 20 million people.

I hope he challenges Republicans and tells them they can create something better than ACA&#x2F;Obamacare. Get them on board with that. Then challenge them to send him something better than ACA that genuinely takes care of people. Replace ACA - don&#x27;t gut it without replacement. If he can do this it could humanize him, the Republican party and do the country good. The problem is &#x27;social&#x27; and Republicans don&#x27;t go together... but perhaps Trump is not all that Republican. Perhaps we need an egomaniac to get things moving. Fuelled by the party hate to get anything Obama related erased.<p>I know, I ask and hope too much.

Everyone knows what the solution is. One way or another, the Feds need to provide broader subsidies and some form of reinsurance to the ACA market, the same way they already do to the medicaid market via those states who have expanded medicaid. The question isn&#x27;t what do to, but rather who pays for it, and how. Since the Republicans are historically the party of fiscal constraint, Trump should have much more flexibility to deficit spend than a Democratic President would have. The debt to GDP % will likely increase but we have a couple decades before we find out if that matters or not.