The Price is Right! Trump’s Choice Indicates Push to Repeal and Replace Obamacare

220px-Tom_PriceDonald Trump’s choice of Dr. Tom Price as his nominee for U.S. Secretary of Health & Human Services indicates the Trump Administration will make a serious effort to repeal and replace Obamacare with patient-centered health reform.

After some initial signs of hesitation at actually trying to achieve this six-year old campaign promise, Obamacare’s opponents can now be confident that skilled leadership will wage a sophisticated and likely successful effort to restart health reform. Here are four reasons why:

  1. Dr. Price is a physician, an orthopedic surgeon by specialty, not a career politician. One reason he entered politics was his own experience dealing with the increasing burden of insurance and government bureaucracy.
  2. Dr. Price was Chairman of the House Budget Committee. He knows how to deal with Congress. Especially, he knows the ins and outs of “reconciliation,” the parliamentary procedure which allowed Congress to get an Obamacare repeal bill (H.R. 3762) to President Obama’s desk last year. Reconciliation is a procedure that allows a bill to bypass a Senate filibuster. In the current lame-duck session, Dr. Price has continued to champion reconciliation as the way to maintain momentum on repealing and replacing Obamacare.
  3. Under his chairmanship, the House Budget Committee led the House and Senate to agree on a concurrent budget resolution for FY 2016, the first in six years! If President Obama had cooperated, this would have re-instituted businesslike budgeting for the U.S. government. A post-Obamacare health reform will likely include significant changes to how the U.S. government will finance and subsidize access to health care. Dr. Price’s experience will allow him to discuss the options thoroughly with the Treasury Secretary and other members of the cabinet who will be involved, as well as a cooperative Congress.
  4. Dr. Price first introduced his own health reform bill in 2009 and has re-introduced and improved it in every Congress since. He knows how to negotiate health reform legislation with his Congressional colleagues, an experience which will serve him well in the Administration.

The choice of Dr. Price to lead the U.S. Department of Health & Human Services should make proponents of health reform that puts patients and doctors – not politicians and bureaucrats – in charge of our health care very optimistic about positive change in 2017.

Comments (30)

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  1. Ronald Greiner says:

    If America wants to control the Globe we have to make some changes that Dr. Tom Price can spearhead. We are NEVER taking over if the price of workers’ health insurance is embedded into the cost of our products or services. Lee Iacocca knew in ’79 that the health insurance albatross was losing it’s power of flight. Iacocca loved Democrats so he was confused. He should have said, “When we lift the cost of health insurance off the backs of American employers the economy will soar like never before and fulfill President-Elect Donald Trump’s slogan of – making America great again.

    Dr. Tom Price is tweaking the tax code to subtract the cost of workers’ health insurance from American products which drives our prices down on a competitive world stage.

    We will have to build that wall to stop all of the Mexicans from flocking over our borders to get tax-free HSA VISA cards, with investment options, and all of our capitalistic prosperity.

  2. Jimbino says:

    In the interest of liberty and common sense, Price needs to offer a plan that de-couples insurance and medical care, favoring HSAs with pre-tax dollars that can be spent directly on health care in the vast network anywhere in the world.

    The last thing we need is compulsory health insurance funded with pre-tax dollars that is limited to a small domestic network.

    • Ronald Greiner says:

      Sure, pre-taxed HSA funds have no restrictions in which country the funds may be used for Qualified Medical Expenses (QME). Consumers have the FREEDOM to spend their HSA funds world wide and [[travel expenses]] may be a QME.

      It’s like the tax-free HSA is made of 1 part common sense, 1 part liberty and 1 part magic.

  3. John Fembup says:

    “should make proponents of health reform that puts patients and doctors – not politicians and bureaucrats – in charge of our health care very optimistic about positive change in 2017.”

    Well it sure makes me optimistic.

  4. lee Benham says:

    Tom Price is the Asteroid that killed the Dinosaurs.
    I have said numerus times on this blog that dismantling or trying to fix the unfixable ACA will cause the extinction of employer based health insurance.
    The availability of Age based tax credits to healthy individuals will make taking benefits from an employer financially irresponsible.
    Why would an employer spend $20,000 a year on health insurance when the employee could take tax credits and buy a personal and portable individual plan to meet their specific needs?
    The delinking of HSA plans and health insurance will allow employers to simply contribute to the health savings accounts instead of purchasing the insurance on behalf of the employee.
    I know Barry will ask what about the sick.
    The sick will go into state high risk pools and yes, the insurance will be much more expensive than individually underwritten.
    We will see an explosion in the sale of Living Benefit Life insurance so people will have the funds to help pay the premiums of the high risk pools if they get sick.
    People will buy inexpensive term life insurance that have Critical Illness, Chronic Illness and terminal illness riders that they can accelerate the benefits if they get sick and have to go to the high risk pools.
    As an example a 50 year old male can buy a $200,000 Life policy for around a $100 a month today.
    He would have access of up to 80% of the face value of the life policy for Critical, Chronic or terminal illnesses.
    We are on the verge of a paradigm shift in how the American Public pays for their health care. The 70 year albatross of employer based health insurance is finally coming to a swift a well-deserved death.

  5. Bob Hertz says:

    Some corporations will go on spending $20,000 per family because their employees would rather have a first-dollar, wide-network, corporate policy — versus the kind of high-deductible, narrow-network, high premium policy that will actually be available with tax credits.

    Say I am 60 years old and have a spouse. Our total tax credits will be $6,000 in the Price plan. The premiums for 60 year olds are high right now in the ACA, but they will be even higher in the Price plan since the 3:1 ratio goes away.

    So my choices are a corporate plan with a $1,000 deductible for which I pay next to nothing, versus a private plan that costs $22,000 a year less my $6,000 tax credits.

    You can say that my scenario above is less true for younger persons, and that is true. But many corporations are run by 60 year olds.

    • Ronald Greiner says:

      Bob, you are stuck in the pea picking past. The premium for a 60-year-old couple in Tampa Bay for a $5,000 deductible STM PPO is $499.98 per month (34691 zip code). There are 850,000 doctors and 7,000 hospitals in network. Of course the 3 to 1 ratio is already gone and the 60-year-old female is less expensive than the husband.

      Sorry Bob, Obamacare is a nightmare that soon will be just a bad memory.

      Remember Bob when you, Obama and Hillary lied and said, “If you like your plan you can keep your plan and keep your doctor too — PERIOD!”

  6. Lee Benham says:

    Sorry I think you are completely incorrect. Let’s use your example of the 60 year old couple.
    Two 60 year olds work for separate companies A and B. companies are in the same business and are competitors.
    Company A offers group insurance benefits that cost $6,000 for an individual and $22,000 for family coverage.
    Company B does not offer a group insurance benefit but places $200 a month into Employees individual HSA or $400 into a family’s.
    Company B Employee buys a $5,000 deductible HSA. Qualified plan for about $600 a month using the $6,000 tax credits.
    Company A and B bid on the same project. Tell me Bob which company has a competitive advantage?

    • Ronald Greiner says:

      Lee, with the Price is Right we will end up with “Beefed Up” tax-free HSAs with larger annual deposit limits like $5,000 for a single and $10,000 for a family.

      A 25-year-old couple depositing $10,000 for 40 years and getting 10% annual rate of return would have $4,868,518 HSA balance at 65-years-old. These people would be better prepared for 21st Century Medicare than the Baby Boomers turning 65-years-old today with ZERO HSA balances. How much would they have at 75-years-old?

      At 75: $12,802,992.00

      Here is a HSA calculator:

      Bob doesn’t want to target wealth to the poor, geez.

      • Barry Carol says:

        10% return is pie in the sky. 6.5% might be more like it for a balanced account. Even for an all equity account, 8% would probably be a stretch assuming 2% average annual inflation.

        • Ronald Greiner says:

          Barry, are you saying nobody has ever had a 10% annual return on investment?

          In Omaha Warren Buffet did better right?

          Lee is from Omaha so he would know.

          Remember Barry, you can put real estate in your tax-free HSA.

          • Barry Carol says:

            I’m looking forward, not backward. Moreover, even Buffett says it’s irresponsible for pension funds to use an assumed investment rate of return of more than 6.5% going forward which is what Berkshire Hathaway uses.

            • Lee Benham says:

              6.5% rate of return! good luck. Thank god there are no pensions with funding problems.

              why not show a 2% guaranteed growth. 2% guaranteed tax free growth is still a damn good deal.

      • Barry Carol says:

        How many 25 year olds outside of Wall Street and Silicon Valley hotshots could afford to deposit $10K per year into an HSA? Not many.

        • Ronald Greiner says:

          You are so negative Barry. You see no problem spending $24,000 a year on this young couple for employer-based health insurance but you, like Hillary, don’t want $10,000 going to the worker in a tax-free account.

          In Council Bluffs, IOWA, across the river from Omaha, 51501 zip code, this 25-year-old couple can get a $2,500 deductible STM PPO for $1,929 a year.

          Barry, you can put $10,000 a year in the couple’s HSA and still be half price of the over-priced employer-based health insurance that you love.

          Can you see how confused you are Barry?

  7. Devon Herrick says:

    Health care seems complicated from the outside but is really not that difficult. We have created a system where nobody competes on price and quality. If providers were not encased in the straightjacket of third-party payment, they would look for ways to streamline their business models to appeal to their customers. More direct interaction between patients and providers would go a long way to improving health care

    • Ronald Greiner says:

      Devon, we have created a system where everybody is brainwashed into oblivion by unending propaganda. We privatize the profits and socialize the loses in employer-based health insurance. When workers are too sick to work we dump them on the “exchange” and a different insurance company will pay all of the medical bills — smooth —

      Aetna Stock on 1/1/2014 $67 — TODAY: $135.57

      What is wrong with this picture?

  8. Barry Carol says:

    Here’s a question for Lee, Ron or Bob. How much cheaper in percentage terms would a typical ACA exchange plan be if it didn’t cover mental illness, alcohol and drug abuse treatment, chiropractic care and maternity benefits? Isn’t that part of what Senator Price wants to do?

    • Ronald Greiner says:

      It was called Mental Health Parity that mental health professionals have always wanted. Yep, the insurance company will charge you more if you smoke but not if you need a $800,000 liver.

      Price is not a Senator.

      Trust me, a self-employed individual is not going to pay any attention to anything a mental health professional has to say so why should they pay for it. I have met self employed people that didn’t go to the doc when they had their heart attack.

  9. Bob Hertz says:

    Lee,you are correct that where firms bid for business and unions are not dominant, then the firm with a cheaper but decent health plan will have a competitive advantage.

    The big old plans of today would then survive in government, education, and very high wage firms.

    One small item — in my example, the $6000 tax credit has to cover both spouses. Price is proposing $3000 a person for older individuals. Your quote assumes each spouse would have a $6000 credit.

    • Lee Benham says:

      No Bob. My quote was for the couple .


      I think you are missing the point. From this point going forward you will see small business and then larger business adapt to the individual tax credit plans. The paradigm shift will happen as the healthy turn down employer based plans to claim the tax credit. The last 60 years group insurance has dumped the sickest into the individual market. Now the sickest will beg for employer based plans driving the costs ot them up. There is no saving employer based plans. This should,have happened in 1996 with the HIPPA laws. Unfortunately we had a Clinton in charge so we had to wait 20 years.

  10. Lee Benham says:


    Before I answer your question I would like to first ask you one simple question.

    What do you think health insurance Is for?

    • Barry Carol says:


      It’s for high cost events that most people can’t afford to pay for out of pocket. It’s not for the human equivalent of oil changes that can be budgeted for.

      • Lee Benham says:

        I’m just guessing but I think as much as 30% less depending on age.
        Let me explain:
        I pulled a file on one of my clients that I tried to talk out of buying Maternity benefits Remember this is pre ACA.
        I asked the couple who were in child bearing years why they wanted Maternity covered.
        They said well you never no. There could be a complication or she might need a C-section or god forbid a pre mature birth.
        My answer to them was: yes you could have all of those problems.
        My next question to them was: how much do you think the Maternity rider on your policy will pay for those problems? They had no idea.
        I explained to them that the Maternity Endorsement only covered Normal Routine Births. Complications of pregnancy are covered under the base policy not by the Maternity Rider.
        So how much was the Maternity Rider? The Rider by itself was $235 a month. The couple had a $2500 deductible 50/50 co insurance to $4000 plan for a max out of pocket $4,500. That policy cost them $248 a month.
        What would they get for $235 a month? A normal Birth in Omaha at that time ran between $6,000 to $8,000 depending on the hospital and Doctor charges. The Maternity Rider had a 9 month waiting period before conception. That means the insured would be guaranteed to make a minimum of 18 premium payments to the insurance company if they got pregnant the first day they were eligible for benefits. So the couple will spend at least $235 x 12 =$4,230 in premiums. They then have coverage for let’s say the $8,000 birth. So the couple pays the $2,500 deductible and then has 50% coverage of the next $4,000. The couple pays the $4500 out of pocket and the insurance company pays the $3500 difference.
        Who would do this if they knew the actual costs and benefits? (yes this couple is one of the few I could not talk out of buying it.)
        Insurance companies are not in the habit of losing money so all they are doing is making insureds pre finance the claims.
        Do you think Johnathan Gruber knew Maternity was a pre financed claim when he mandated it be covered?

        • Barry Carol says:

          Gruber probably did know but the liberals all want first dollar coverage for everything. The single payer system that they tried to sell in VT had an actuarial rating of 94%!! That’s the equivalent of car insurance covering oil changes and tire rotation or homeowner insurance covering gutter cleaning and lawn mowing.

          • Ronald Greiner says:

            “If we had a Food Security Card, that paid for 1st dollar food, we would all be eating differently and so would my dog.” Senator Phil Gramm (R-TX) 1993

            My dog would eat T-Bones if taxpayers are buying.

  11. Ronald Greiner says:

    Lee, you ask, “What do you think health insurance Is for?”

    Health insurance is a way to grab billions of dollars and bribe politicians with millions of dollars to make all of the competitors illegal.

    Think of Al Capone.

  12. Lee Benham says:

    Another Obamacare problem.

    I took my 4th call this week from clients that are getting automatically enrolled into new ACA plans because the company they had is leaving the exchange and won’t be available.

    The problem is, all of these clients are over 65 and have had Medicare advantage plans all of last year. I had them call the market place and the market place told them they have no idea how old they are so they have just been auto enrolling the clients. So these 4 clients that had Coventry Medicare Advantage plans were also on ACA plans with tax credits going to Coventry. I’m sure I’m the only agent taking calls like this.

  13. Bob Hertz says:

    Lee, you made a good point about how the healthier employees will favor a different kind of company plan than the sicker ones.

    Your comment is a perfect reflection of what I am going to call a “hidden tension” in American health care policy.

    The tension is this:

    Healthy people have a natural economic interest in separating themselves financially from sick people.

    Sick people have a natural financial interest in social-solidarity programs, that essentially take some money from healthy people.

    Republicans and libertarians are generally on the side of full health underwriting, HSA accounts, and coverages like maternity as riders.

    As I once mentioned to my wife, you do not see many wheelchairs at libertarian conventions.

    Democrats are generally on the side of guaranteed issue, taxpayer funding, and mandatory benefits.

    This is nothing recent! Harry Truman wanted Medicare, the Republicans under Robert Taft wanted private insurers to take care of the elderly, the early commercial insurers stole the healthier employer groups from Blue Cross in the 1960’s, etc.etc.

    Today, there is a certain ‘buzz-word’ in some Republican proposals to the effect that they will help individuals get “a policy that best suits their needs.’

    Hey guys, the real translation is “Our system will let healthy people get cheap insurance again.”

    America has just had 4 years of the ACA, which of course was a move for solidarity, and making healthy people pay for sick people. There is going to be a backlash against this effort, and the Democrats basically asked for it by not expanding Medicare.
    (I can explain my viewpoint in a longer post.)

  14. Lee Benham says:

    Zek Emauel was on TV again today saying how great a job the ACA has done especially in keeping group insurance prices under control.

    He stated that no insurance market will work without mandates. I would argue that every kind of insurance sold in America before the ACA did not have mandates and operates well without them. What he should have said is guaranteed issue would not work without mandates. This is also just a load of crap but at least he wouldn’t have sounded like a complete idiot.

    What the politicians have not figured out is the transference of risk that drives every insurance market.

    If the poor have no risk to transfer then what incentive do they have to purchase a product?

    Even if their cost is less than the price of a pizza a month they still will not have incentive to forgo the pizza and transfer the risk. ,