Staff Editorial

Trump's health care points were laudable, but Iowans can't take his word for it

President Donald Trump greets people after he delivered his State of the Union address to a joint session of Congress on
President Donald Trump greets people after he delivered his State of the Union address to a joint session of Congress on Capitol Hill in Washington, Tuesday, Feb. 4, 2020. (AP Photo/Patrick Semansky)

At the State of the Union address this week, President Donald Trump made several statements on health care that should be encouraging to Iowans. However, past experience makes us skeptical about whether the president will follow through.

Trump said Tuesday he would protect patients with preexisting conditions. That’s a follow-up to his claim a couple weeks ago that he is “the person who saved Pre-Existing Conditions in your Healthcare.”

Previously, Trump has promised to eliminate the Affordable Care Act, the Obama-era law requiring insurance companies to cover people with preexisting conditions. The Trump administration is currently supporting a federal lawsuit seeking to dismantle the ACA.

More than 1 million Iowans have preexisting conditions and potentially face coverage denials or significantly higher prices if protections are struck from the law, according to Protect Our Care, a pro-ACA advocacy group.

Despite the president’s statements to the contrary, Trump’s Republican supporters in the Iowa Legislature understand protections for preexisting conditions are at risk of being lost. They’re sponsoring a bill prohibiting coverage exclusions for preexisting conditions, which would only take effect if the courts rule against the ACA.

Trump also said he would protect Medicare, even though his administration’s latest budget proposal included significant cuts to Medicaid and Medicare. That would be harmful to more than a million Iowans served by the two programs.

Trump called for prescription drug pricing reform. He praised Iowa’s Sen. Chuck Grassley, who is sponsoring legislation to cap out-of-pocket spending for seniors, but failed to mention House Democrats’ prescription legislation. They are both good bills and should be starting points for bipartisan collaboration.


Trump touted his cost transparency executive order, which will require hospitals to publish price lists. It’s a smart idea, but he oversold it by saying it would be “even bigger than health care reform.”

That statement, along with Trump’s claim that Americans are “very happy” with their private insurance, suggests there’s no interest on his part in any significant health care reform. That’s a mistake.

Yes, most Americans support keeping some form of private insurance available, but that’s a far cry from insisting patients are pleased with the coverage, cost and accessibility of the existing system. More than 100,000 Iowans are uninsured, and many more are underinsured or cost burdened.

Trump may have said many of the right things in his speech this week, but Iowans can’t take his word for it. Improving health care access will require persistent pressure to hold Trump accountable to his promises.

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