Presumptive GOP presidential nominee Donald Trump is nothing like the party's previous nominees, so it isn't surprising that the GOP health policy platform only days ahead of the convention remains largely unknown—very unlike 2012 or 2008.
Health policy experts say there is even considerable uncertainty about who will drive the health platform at the Republican National Convention in Cleveland starting July 18. Normally, the nominee's campaign staffers work with congressional committee staff, conservative policy experts and key lobbying groups to draft the health and other policy planks on which the nominee and congressional candidates will run.
But this time around, experts at conservative think tanks and lobbying groups say they have not been asked to participate by either the Trump campaign or the Republican National Committee. They've been kept in the dark about how the platform will be written.
That's at least partly because those traditionally Republican-aligned players are not necessarily in sync with Trump and his stated views, including his repeated rejection of cuts in Medicare and Medicaid. Some business groups and lobbyists are opting out of the convention entirely.
“Given that it's Trump, the professionals probably don't line up very well with where Trump comes out,” said Joe Antos, a health policy expert at the conservative-leaning American Enterprise Institute. “It's really a mystery this year.”
“I don't know who will have influence,” said Chip Kahn, CEO of the Federation of American Hospitals, which canceled a planned health policy seminar at the Republican convention for lack of news media interest. “Like everything with Trump, it's all new and different.”
The big question is whether the presumptive nominee and his campaign will embrace, as the basis for the platform, all or part of the comprehensive health policy white paper released last month by House Speaker Paul Ryan and other top House Republican leaders to repeal and replace the Affordable Care Act. That 35-page document includes controversial proposals to cap and cut spending on Medicare and Medicaid and tax employer health benefits.
The Trump campaign's vague seven-point health policy agenda released in March contains concepts similar to the House GOP proposal. It backs turning Medicaid into a state block grant program, but does not address Medicare or taxing employer plans.
Conservative health policy experts hope the GOP platform will include the House Republican ideas as its centerpiece, though probably with less specific language. The House plan articulates long-standing conservative policy principles and formed the heart of the 2012 Republican health platform. That year's document proposed without detail to “save Medicare by modernizing it, by empowering its participants, and by putting it on a secure financial footing.”