Trump’s Updated Health Proposals Still Leave Questions

President-elect Donald Trump’s most updated health care proposals don’t say whether a Trump health care policy would require insurers to cover pre-existing conditions or whether the law would continue an expanded Medicaid program.

Those are two of several questions that advocates and observers are posing about how Trump plans to replace the Affordable Care Act, which bars insurers from denying covering to people with pre-existing health conditions.

Then there’s this. The biggest challenge that Republicans face in attempting to advance health reform is how to continue covering the 20 million people who gained have insurance under the ACA.

Trump’s latest proposals are outlined on his new website for the presidential transition, greatagain.gov. Health overhaul has emerged as one of the top priorities for Republicans since sweeping the White House and both chambers of Congress in Tuesday’s election.

The health care page says a replacement plan for Obamacare would include the use of health savings accounts and returning regulatory power back to the states.

“The administration’s goal will be to create a patient-centered healthcare system that promotes choice, quality and affordability with health insurance and healthcare, and take any needed action to alleviate the burdens imposed on American families and businesses by the law,” the proposal says.

The Trump administration will work with Congress to allow insurers to sell policies across state lines and to re-establish high risk pools, which the transition site says is “a proven approach to ensuring access to health insurance coverage for individuals who have significant medical expenses and who have not maintained continuous coverage.”

The incoming administration also wants to give states flexibility in administering Medicaid “to enable States to experiment with innovative methods to deliver healthcare to our low-income citizens.”

Many of the people who have gained health coverage under the ACA have done so because they live in a state that opted to expand Medicaid to cover more low-income people. While Trump’s current plan doesn’t indicate whether that would be continued, Vice President-elect Mike Pence did choose to expand the program as governor of Indiana in a non-traditional way, using a federal waiver.

The site also says the incoming administration will protect individual conscience in health care, as well as protect life from conception to natural death, advance research and development in health care, reform the Food and Drug Administration to maximize patient benefits for new products, and modernize Medicaid.

The ACA “has not been a success,” the website says.

“The administration recognizes that the problems with the U.S. health care system did not begin with — and will not end with the repeal of — the ACA,” the website says.