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AAF President on Trump’s health care executive orders: ‘This looks a lot more like campaigning than governance and policy’

American Action Forum President Douglas Holtz-Eakin joins Yahoo Finance’s Akiko Fujita to discuss President Trump’s latest health care measures.

Video Transcript

AKIKO FUJITA: President Trump, laying out his vision for health care yesterday, with two executive orders announced, one protecting patients with pre-existing conditions. The other, directing Congress to pass legislation that addresses surprise medical billing. This, of course, comes with less than six weeks to go before the presidential election.

Let's bring in Douglas Holtz-Eakin. He is the American Action Forum president. And Doug, it's always good to talk to you about these issues. Let's just talk about the timing of this. Because we have heard the president, over the last several months, really tease this plan about this grand health care plan. And yet, what we got yesterday was two executive orders, a week out from the first presidential debate.

DOUGLAS HOLTZ-EAKIN: Yeah, this looks a lot more like campaigning than governance and policy. The executive order on pre-existing conditions says that, you know, we, the American people, want those preexisting conditions to have insurance. It doesn't direct anyone to do a rulemaking, it doesn't change policy in any way. Indeed, everyone with preexisting conditions is protected by the Affordable Care Act. And at this moment, the administration is supporting a lawsuit to get rid of the ACA. So that's really not to substantive of a move.

And the one surprise medical bills, again, the administration's not doing anything. He's just saying, you, Congress, need to pass law on this. And if you don't, on January 1st, I will tell the secretary of HHS to do something. What? We don't know.

AKIKO FUJITA: A lot of questions. You look back to 2016 when the president campaigned, it was really all about repeal and replace Obamacare. Now you've got the president arguing for an executive order, what is at the core of the ACA. I mean, how much of this was just about re-branding?

DOUGLAS HOLTZ-EAKIN: I think a lot of this is just re-branding. And they want to have as the dominant theme, promises kept. And among his promises were to repeal and replace the Affordable Care Act. That's why they continue to support this lawsuit, that's why he's out there doing executive orders to say, look, here's the replacement plan, we've got something. And, you know, he wants to go into the election in that position. And I don't think there's anything deeper than that going on.

AKIKO FUJITA: Let's talk about the concerns around the ACA right now, when you look ahead to the upcoming Supreme Court session. We're talking about this case, California versus Texas, which is likely to determine the future of the Affordable Care Act. It's not going to be taken up by the court until after the general election.

But how should we be looking at this case? There's a lot of patients who are looking at the headlines saying, is Obamacare going to be overturned altogether? And it sounds like you're quite skeptical that there will be a significant change as a result of this Supreme Court case.

DOUGLAS HOLTZ-EAKIN: I am skeptical. The case focuses on the constitutionality of the individual mandate. They're not enforcing the mandate now. They got rid of the tax penalty in the tax cuts and jobs act. So there's no effective mandate. If it's declared unconstitutional, nothing really changes. The only issue is whether you can get rid of just that piece of the ACA, and leave the rest, or will the court rule that it's not quote "severable," and the whole thing has to go. That's the extreme version.

Even if they did that, the court would probably say, OK, this ruling will not take effect immediately. It will begin in, you know, June 1st of 2021, and a Congress and a president, whoever wins in November, will have to pass legislation. It would essentially be the Affordable Care Act without the mandate. Or, if Democrats control everything, they could have something like the Affordable Care Act on steroids. So it would be extremely ironic if Republicans tore down the ACA, only to get back something that's even bigger, and more intrusive.

AKIKO FUJITA: One of are the interesting proposals, I thought, kind of stood out when the president spoke yesterday, is this a $200 discount, I think is what he called it, towards the cost of prescription drugs. Now we've learned that it's likely to be funded through Medicaid. How far does $200 get you, especially for seniors, who have got a huge bill on prescription drugs? I mean, what do you make of the cost that's available there, and the ability to pay for it?

DOUGLAS HOLTZ-EAKIN: Again, you know, the president said we're going to do this, but he didn't say how. And we haven't really heard an answer on how yet. This is about 6 and 1/2 billion dollars. And Congress didn't appropriate six and a half billion dollars to this purpose. So they would somehow have to reprogram existing money to do it. And there's always a question about whether they have the authority to do that.

It's also not clear how you would be able to use that $200. You could imagine, if you could use it only in 2020, you might actually not have the $200 worth of costs to cover. If you can carry it into next year and have, you know, a big deductible, it might help you over the course of a longer period. So there are a lot of unanswered questions here.

And, you know, I think many people are skeptical of the proposal just because of the timing. Why is it that now, suddenly, a few weeks out from the election, we need to have $200 more for each senior? That's something that could have happened at any other time as well.

AKIKO FUJITA: And Doug, finally, if we can bring this back, in the context of the election, you know, you pointed to the fact that Republicans actually like Obamacare now. They have seen how it has all played out. How significant do you think health care is going to be as an issue for those voters, particularly the older voters? And if that's the case, how do you think the Trump campaign, in the remaining six weeks-- five-- I think it's five weeks now, under five weeks. How do they address this issue, sort of toe the line between criticizing what is there now, but also saying we're going to keep the parts that you like?

DOUGLAS HOLTZ-EAKIN: Yeah, I certainly think that the image of Obamacare, as a whole, has changed. The law was always as popular as then President Obama was. Since he's left office, it's become steadily more popular. And inside of that, when asked about individual components, like keeping your kids on your insurance till they're 26, they were supported in a bipartisan fashion. So it's hard for me to imagine a wholesale dismantling of what we have right now. That just won't fly.

I think the bigger issue is a lot of health care costs are still too high. Prescription drugs are the poster child for this. So if you can talk about bringing down the cost, that's certainly what the president's trying to do. Then you can not be threatening what people like, but also have something to offer in the health care debate.

AKIKO FUJITA: Douglas Holtz-Eakin, always good to talk to you. He is the president of the American Action Forum.