Donald Trump has no idea what health insurance costs

The president estimated that the Republican bill would save “$400 to $900 billion” in government spending — an amount significantly higher than the $337 billion in savings that the Congressional Budget Office has referenced in its analyses of an early version of the bill.

But perhaps most concerning to health insurance plans was the uncertain answer he gave on whether he would continue paying a key Obamacare subsidy program, known as the cost-sharing reduction subsidies. If Trump stopped making those payments, which are currently challenged in court by House Republicans, it would leave insurers with about $8 billion in unpaid bills.

“We’re subsidizing it and we don’t have to subsidize it,” Trump told the Economist, referring to the law’s contested cost-sharing reduction payments. “You know if I ever stop wanting to pay the subsidies, which I will…”

Trump’s answers likely don’t give much comfort to the insurance plans that participate in the Obamacare marketplaces right now, which have begged for more certainty on this particular issue. And they don’t suggest that Trump has familiarized himself with the details of the Republican health care plan either.

Trump has reiterated his promise that Americans will have “guaranteed absolutely coverage.” The Republican plan doesn’t deliver that.

The Economist asked the president about the fact that many Americans are expected to lose coverage under the Affordable Care Act. This was Trump’s response to that question (emphasis added):

The state governments are in much better position to, you know, help people. In terms of, you know, just the size, the mere size of it. But we’re putting in $8bn and you’re going to have absolute coverage. You’re going to have absolute guaranteed coverage. You’re going to have it if you’re a person going in…don’t forget, this was not supposed to be the way insurance works. Insurance is, you’re 20 years old, you just graduated from college, and you start paying $15 a month for the rest of your life and by the time you’re 70, and you really need it, you’re still paying the same amount and that’s really insurance.

Trump makes a promise of “guaranteed coverage.” But the Republican bill doesn’t deliver on that. When the Congressional Budget Office analyzed the last version of the American Health Care Act, it estimated that 24 million fewer Americans would have coverage if the bill were to pass.

As Trump mentions, the more recent iteration of the bill adds an additional $8 billion to fund high-risk pools, but analysts of all political stripes agree that is not nearly enough to cover all the Americans who would want access to those programs.

There’s also this other line in the response that caught my eye, where Trump discusses how he thinks health insurance ought to work.

“Insurance is, you’re 20-years-old, you just graduated from college, and you start paying $15 a month for the rest of your life and you really need it, you’re still paying the same amount and that’s really insurance,” Trump says.

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