Trump’s new health care legacy: Big expansion of federal role

President Donald Trump’s coronavirus fight has turned an administration that spent years trying to shrink the nation’s safety net into the driving force behind a sudden expansion of government involvement in American health care.

The Trump administration is already pumping hundreds of billions of dollars into a key health sector that it previously vowed to rein in, expanding Medicare benefits and boosting payments to state Medicaid programs by an estimated $50 billion, while promising to directly pay for coronavirus treatment for thousands of uninsured in what some experts say mirrors a single-payer system.

By the time the virus finally recedes, some health policy analysts predict, Trump will have overseen historic new levels of federal health spending.

It’s a crisis response that has cast aside a decade of Republican orthodoxy and many of the administration’s original health care goals, in realization that Trump’s health care legacy — and reelection — could hinge on the fate of the next few months.

“President Trump is probably now overseeing one of the biggest expansions in government health spending in one year ever,” said Larry Levitt, the executive vice president for health policy at the Kaiser Family Foundation.

That trajectory has sent ripples of anxiety through parts of the conservative health care establishment even amid a national emergency, over worries that a Trump era once seen as the gateway to smaller government could end up further entrenching the nation’s massive federal health programs.