Trump’s ‘concepts of a plan’ on healthcare is “frightening,” says Florida health care advocate

As former President Donald Trump keeps discussing possible replacements for the Affordable Care Act, a Florida patients’ advocate warns that this could be disastrous for healthcare across the state.  

Former President Donald Trump has “concepts of a plan” to replace the Affordable Care Act (ACA), he said during last week’s presidential debate with Vice President Kamala Harris.

Trump’s response came after ABC News moderator Linsey Davis asked if he had plans to get rid of the ACA, which he repeatedly tried to do during his first term.

“I have concepts of a plan,” said Trump. “I’m not President right now, but if we come up with something, I would only change it if we come up with something that’s better and less expensive,” he said, offering no details. 

Florida leads the nation in ACA marketplace enrollment

Under the Affordable Care Act, people who were previously uninsured due to preexisting conditions or financial circumstances were given access to quality health care with ACA-compliant plans that cover things like annual checkups, maternity and newborn care, prescription drugs, emergency services, mental health services, pediatric services and more.

Now, as he runs for president, Trump is again toying with replacing the ACA, a goal that – if successful – would affect a record 45 million people who have coverage through the ACA exchanges or the law’s Medicaid expansion, according to federal data. 

Those who would be impacted include the more than 4.2 million Floridians that signed up for the federal health care marketplace for 2024 coverage, according to data from the Centers for Medicare and Medicaid Services. That number represents a 31% increase from last year — and a more than 54% jump from the year before that. In fact, Florida currently leads the nation in health insurance enrollment through the Affordable Care Act exchanges. 

“Repealing the ACA and replacing it with anything providing less coverage would be a tremendous loss for Florida and the rest of the country,” Kenneth Klein, a BCPA (Board Certified Patient Advocate) from Boca Raton, Florida, told Floricua. 

“There are 4.2 million Floridians who enrolled in a Marketplace Affordable Care Act policy in 2024. Additionally, of the 12 million people with individual and group commercial insurance coverage, substantial portions are ACA compliant. Thus, everyone with ACA compliant coverage will lose the same basic guarantees of an ACA plan. There would no longer be guaranteed coverage for essential health benefits such as maternity care, prescription drug coverage, substance abuse treatment, hospitalization, and preventative treatment,” said Klein, who since 2015, has worked to reduce medical debt and increase patients’ access to care. 

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Klein also worries that replacing the ACA would impact preventative care.

“Flu shots, cancer screenings, mammograms, all currently provided to consumers at no cost, would become the subject of substantial charges,” he added.

Even more worrisome, Klein said, is that insurance companies would again be able to impose pre-existing condition restrictions, as well as reimpose lifetime policy caps. 

“I know of several people whose lives have been radically affected by having Affordable Care Act coverage,” Klein recounts. “A young woman contacted us. She needed a liver transplant. She was able to get coverage with an ACA policy with no pre-existing condition limitations or lifetime cap. After consulting with advocates that navigate resources for rare and critical illnesses, a facility and a doctor were located. Given the special enrollment period — the patient purchased the highest tier plan accepted by that facility. No coverage issues whatsoever. She paid her premiums and an out-of-pocket amount. Everything else was the insurer’s responsibility.”     

For all the reasons mentioned, said Klein, “repealing the ACA and replacing it with anything providing less coverage would be a tremendous loss for Florida.”                                                                                                                                                                           

Man on a mission

Trump campaigned on a promise to repeal the ACA in 2016 and kept that position throughout his term, even after Republican senators, notably the late-Sen. John McCain of Arizona, voted against repealing the health care law in 2017. The steps taken by the Trump administration to weaken the legislation signed into law by President Obama in 2010 include:

• Cutting the annual open enrollment period in half to six weeks.
• Slashing the advertising budget by 90%. 
• Cutting funding for enrollment assistance. 
• Eliminating federal payments to reduce deductibles and out-of-pocket charges for low-income participants, prompting insurers to raise premiums. 
• Signing an executive order that made it easier to access alternative policies with lower premiums than ACA plans in exchange for fewer protections and benefits. These plans can deny coverage to people with preexisting conditions or charge them higher premiums.
• Signing a bill to eliminate the individual mandate, which required most Americans to have health insurance or face a penalty. 
• Supporting a major court challenge to the Affordable Care Act’s constitutionality. The Supreme Court ultimately dismissed the challenge, keeping the law in place.

A real threat 

Debbie Mucarsel-Powell, the former Florida Democratic representative who is running to unseat Republican Sen. Rick Scott in November, says she has no doubt that if elected, Trump intends to do away with a healthcare program that millions of Floridians depend on. 

“[The presidential debate] proved what we’ve known all along,” Mucarsel-Powell told Floricua. “Extremist Republicans like Donald Trump are more than ready to overturn the Affordable Care Act and rip away quality and affordable health care from over 4 million Floridians overnight, including those with pre-existing conditions.”

“It is frightening to think that our health care is in the hands of politicians working with Trump,” said Klein. 

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