By Megan Stamm*
One of President Trump’s promises during the 2016 election was repealing Obamacare. President Trump never hid his opposition to the universal healthcare system. Trump stated, “Obamacare is a disaster. You know it. We all know it.” President Trump and many republicans have issues with the Affordable Care Act. Some of these issues consist of ideological differences, such as opposing government policies that require people to buy insurance under threat of tax.  Some also view the Affordable Care Act as a welfare program that supports the lazy with hard worker’s money. Others criticized the Affordable Care Act by attacking its premise, arguing it promotes high deductibles and premiums and is not affordable at all. Regardless of their reasons, the Trump administration promised its constituents that the Affordable Care Act would be repealed and replaced. In an unsurprising twist, the proposed changes will exacerbate the issues they are designed to fix.
For months, the American people believed the Trump administration would repeal the Affordable Care Act before instituting a new system. Had this happened, 18 million people would have lost their healthcare. Additionally, those who would keep their insurance would face an additional 20% to 25% hike in premiums. The Trump administration decided to take a less drastic route. President Trump’s administration has released proposals for the Affordable Care Act. These changes range from changing open enrollment requirements to decreasing restrictions on the insurance companies. These changes are likely to have disastrous effects on the healthcare system in the United States and will ruin the foundation of universal healthcare.
The Trump administration is proposing a few changes to open enrollment. One change is shortening the time to sign up for insurance. The old time frame to sign up for insurance in the market was 12 weeks. The new change will cut this time down to 6 weeks. This change is proposed as a way to eliminate people signing up for insurance when they are sick and then dropping coverage when they are healthy again. The only way for universal healthcare to work is if healthy, young people buy into the system and stay there. Insurance works by having people purchase insurance plans. Usually people have to pay monthly for their insurance plans, whether they are sick or not. All of this money goes into a pot. When someone gets sick, money is withdrawn from the pot to partially pay for the ill’s medical expenses. The more people that buy insurance, the more money in the pot, the more money available to pay for medical expenses, and premiums fall. When people drop out and stop paying their premiums, money is withdrawn from the pot, and premiums rise for those that are still insured.
If open enrollment is decreased from 3 months to 6 weeks, less people will sign up for insurance in the free market. To take this a step further, it will probably result in less healthy people signing up for health insurance. The reason the system needs healthy people to sign up for health insurance is because those people will not be drawing money out of the pot and using it on medical costs. Instead, they will put money into the pot – by buying insurance– as a safety net for the inevitable day they get sick and need to use their insurance. In the end, this new change will not correct the problem it was intended to correct. Instead, it will exacerbate the issue.
Eliminate Grace Periods
Under the current system, disadvantaged people have 90 days to pay their premiums before having their insurance taken away. This encourages people to keep paying their monthly insurance premiums because it gives these individuals more time to make the money needed for the monthly payments.by giving them a chance to get the money that would enable them to stay in the system.  The proposed change is to will eliminate this grace period and suspend coverage to those who fail to pay their premiums immediately. The result of this change will be that more people will lose insurance, more money will be lost from the pot, and premiums will rise for those who remained insured. 
Decrease Regulations for Insurance Companies
The new system will allow insurance companies to eliminate transparency. Under the current system, customers are allowed to see whether they have access to qualified doctors and hospitals that will be covered under their insurance plans. The new system will make it harder for customers to obtain this information. The result will be people will not have the luxury of seeing a variety of doctors. This could result in the quality of health decreasing because people will be forced to see inferior doctors and travel farther distances for quality health.
The overall effect of these changes would inhibit progress towards universal healthcare. Ironically, the Trump administration’s attempts to combat high premiums under the current system will only exacerbate the issues. The proposed changes will make it harder for people to enroll in insurance plans and will discourage young, healthy people from enrolling. People will not want to obtain health insurance if they cannot easily qualify. They especially will not enroll if they are not allowed to see qualified health care professionals. If less people enroll, then premiums will rise because the few that are insured will have to cover the medical costs for each other. The new system will not make healthcare assessable to all people. Once again, the poor and disadvantaged are over looked and not cared for.
The views and opinions expressed in this blog are those of the authors only and do not reflect the official policy or position of the Michigan Journal of Environmental and Administrative Law or the University of Michigan.
*Megan Stamm is a Junior Editor on MJEAL. She can be reached at firstname.lastname@example.org.
 Donald Trump on Healthcare, On the Issues, http://www.ontheissues.org/Donald_Trump.htm (last visited Feb. 27, 2017).
 Alison Kodjak, Trump Can Kill Obamacare With or Without Help From Congress, National Public Radio (Nov. 9, 2016, 7:05 AM), http://www.npr.org/sections/health-shots/2016/11/09/501203831/trump-can-kill-obamacare-with-or-without-help-from-congress.
 M.J., Why Republicans Hate Obamacare, The Economist (Dec. 11, 2016,),
 How Insurance Works, Blue Cross Blue Shield of Minnesota, https://www.bluecrossmn.com/healthy/public/personal/home/shopplans/shop-individual-family-plans/shop-how-health-ins-works (last visited Mar. 15, 2017).
 Lydia Mitts, President Trump’s Proposed ACA Changes Favor Health Insurers at Consumers’ Expense, Families USA (Feb. 15, 2017), http://familiesusa.org/blog/2017/02/president-trump-proposed-aca-changes-favor-health-insurers-consumer-expense.