A Letter to President-Elect Trump About Obamacare

January 12, 2017


Dear President-Elect Trump,

I am one of countless American special needs families that will be most affected by the repeal and replacement of Obamacare. I respectfully request that you read this letter.

I’ve worked with and corresponded with hundreds of families, in person and online, about reducing their medical expenses. Their needs vary across the spectrum, but they are all concerned about the sky-rocketing costs of healthcare. Some are satisfied with the provisions of the ACA, but most are concerned, especially these last two years of Obamacare.

Here are some of the most common issues that I’ve encountered from special needs families:

  • Deductibles are too high. One family noted in a Texas Special Needs Facebook forum found out the least expensive plan for just their child had a $6,000 deductible.
  • There is fear that the lifetime cap will be eliminated.
  • There is frustration that EIRSA laws do not require state funded plans to follow state mandates.
  • Many wish for a federally funded mandate for autism coverage.

I agree with some of the suggestions Senator Rand Paul has put forth in his replacement of Obamacare:

  • Allow individuals and small companies to “pool” together to have more collective bargaining power for the best coverage.
  • Legalize all forms of insurance, including catastrophic-only insurance.
  • Expand HSA coverage so that there is no annual contribution limit.

Here are some of my suggestions, some of which I mentioned in my last letter to you:

  • Have employers “match” HSA contributions, similar to a 401k plan.
  • Reduce the threshold for medical expense deductions from 10% to 5% (or less) of AGI.
  • Reverse President Obama’s decision to reduce the Flexible Spending Account threshold. Change it from $2,500 per year to an unlimited amount.
  • Allow “unauthorized” treatments such as medical cannabis to be deductible as a medical expense and reimbursable under a cafeteria plan.

Consider these and other sensible ideas. Retain some of the most important provisions of the ACA. I am inspired each day from the incredible special needs families I interact with. My hope is that you will hear our voices and listen.



Yolanda Ruiz-Leon Baker

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