Trump has stated that he will act to “modernize Medicare.” This phrase refers to proposals like “premium support” (giving people a voucher) and raising the age of Medicare eligibility. Last June, House Republicans in Congress proposed the voucher idea – giving seniors a check and a list of private healthcare plans. Premium support aims to reduce the growth in Medicare spending by increasing competition among private health plans and providing a stronger incentive for beneficiaries to be cost-conscious in their plan selection. Basically it’s a way to “privatize” the Medicare program. If President Trump repeals the Affordable Care Act, it could affect the improved preventive and drug benefits and numerous Medicare savings proposals in the law.
Trump also has said he wants to convert Medicaid, the largest health plan for low-income people of all ages, from an individual entitlement into a capped block grant. Trump would offer states a choice between a Medicaid per capita allotment or a capped allocation. There are 1.9 million people on Medicaid (MassHealth) in Massachusetts. The commonwealth is one of the states that exercised its option under the Affordable Care Act (ACA) to cover most residents with incomes up to 138 percent of the federal poverty level. Five hundred thousand new enrollees joined the program between 2013 and 2016.