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Trump and health care: President gives Congress five principles for Obamacare replacement

President Donald Trump on Tuesday urged Democrats to work with Republicans in Congress to repeal and replace the Affordable Care Act, which he claimed, yet again, is a "disaster."

Trump's request, which he made twice during his first address to Congress, came as he laid out five key measures he wants lawmakers to adopt in replacement legislation for Obamacare.

"Tonight, I am also calling on this Congress to repeal and replace Obamacare with reforms that expand choice, increase access, lower costs, and at the same time, provide better health care," Trump said.

"Obamacare is collapsing — and we must act decisively to protect all Americans. Action is not a choice — it is a necessity."

"So I am calling on all Democrats and Republicans in the Congress to work with us to save Americans from this imploding Obamacare disaster," Trump said.

Trump's outline for replacing Obamacare included:

    • Ensuring people with pre-existing health conditions are guaranteed "access" to health insurance, "and that we have a stable transition for Americans currently enrolled in the health-care exchanges.
    • Giving people who buy their own health coverage tax credits and expanded health savings accounts to help pay for their coverage, as well as flexibility about the design of their plans.
    • Give states "the resources and flexibility" in their Medicaid programs "to make sure no one is left out." Medicaid covers primarily poor people.
    • Legal reforms to protect doctors and patients "from unnecessary costs" that drive up insurance costs, and to bring down the price of high-cost drugs.
    • Creating a national insurance marketplace that allows insurers to sell health plans across state lines.

    Trump said Obamacare's mandate that nearly all Americans have some form of health insurance or face a fine "was never the right choice for America."

    He cited the fact that premiums rose sharply for individual health insurance plans this year, and that one-third of U.S. counties are served by just one insurer that sells individual health plans.

    Democrats have shown no enthusiasm for repealing Obamacare, and have vowed to fight Trump on the issue.

    And Republican lawmakers are split over how to deal with both repealing Obamacare and replacing it.

    GOP members of Congress, during visits to their home districts, have been confronted by constituents at town halls expressing anger and fear about losing their health coverage.

    That angst is likely to grow if a Republican proposal for replacing Obamacare is projected to result in fewer people being covered by health insurance than are currently covered under the program.

    Obamacare has been credited with expanding health coverage to 20 million Americans in the past six years.

    But Trump, during his speech, said there are more than enough reasons for lawmakers of both parties to get together to get rid of the law.

    "Everything that is broken in our country can be fixed," Trump said. "Every problem can be solved. And every hurting family can find healing, and hope."

    The president added, "Our citizens deserve this, and so much more — so why not join forces to finally get it done?"

    "On this and so many other things, Democrats and Republicans should get together and unite for the good of our country, and for the good of the American people."

    Tom Price, Trump's secretary of the Department of Health and Human Services, said after the speech, "Tonight, President Trump reassured the American people that help is on the way for those who are suffering as a result of the Affordable Care Act. "

    "Now is the time for action," Price said.

    But former Kentucky Gov. Steve Beshear, who gave the Democratic response to Trump's speech, blasted the idea of replacing Obamacare.

    "You and your Republican allies in Congress seem determined to rip affordable health insurance away from millions of Americans who most need it," Beshear said.

    "So far, every Republican idea to "replace" the Affordable Care Act would reduce the number of Americans covered, despite promises to the contrary."

    "Behind these ideas is the belief that folks at the lower end of the economic ladder just don't deserve health care – that it's somehow their fault that their employer doesn't offer insurance or that they can't afford to buy expensive health plans," Beshear said.

    He also said, "Does the Affordable Care Act need some repairs? Sure it does. But so far, every Republican idea to 'replace' the Affordable Care Act would reduce the number of Americans covered, despite promises to the contrary."

    He also said said that Republican promises about "access" to care would result in families being charged more for fewer health benefits, and "put insurance companies back in control."