We’re heading into the final stretch of election season. As we look toward November, the uncertain future of the Affordable Care Act (ACA) remains in clear focus. It’s apparent that Donald Trump and Hillary Clinton’s stance on health care reform policies is starkly different, but how so? In order to get at the meat of the issue, I conducted an analysis of positions by visiting each candidates’ websites and diving into their proposed initiatives.
Overall, while Clinton will defend and expand the ACA, Trump will repeal the legislation. Clinton believes health care should be the government’s responsibility and all Americans should have a right to health care. Trump wants to minimize government involvement and leave it open to the free markets. The one thing both candidates have in common is their desire to break up health care monopolies.
Before placing your vote this November, check out each candidates’ plans regarding health care reform:
Hillary Clinton (Source: Hillary for America)
Clinton aims to strengthen the ACA through several means. On her agenda is making a public health care option possible, creating a way for individuals to buy into Medicare at age 55 or older and reducing individual out-of-pocket costs, such as deductibles and copays. While she would allow Medicare to negotiate with drug makers, which is currently prohibited by law, another option to decrease the cost of prescription drugs is to allow the importation of drugs from other nations, as well.
In terms of taxation, Clinton claims she would eliminate the tax deductibility of “direct-to-consumers” drug advertising and use the government tax savings to help fund R&D by manufacturers. Further, by repealing the Cadillac Tax on high value health plans, limiting out-of-pocket costs on drugs for lower income individuals and creating a Federal backstop for high cost drugs, Clinton hopes to limit out-of-pocket costs and ultimately decrease the cost of health care for individuals. Finally, Clinton will allow individuals to buy health insurance on public exchanges regardless of their immigration status.
Donald Trump (Source: Donald J. Trump for President )
Trump has adamantly stated that on day one of his administration, he will ask Congress to repeal the ACA; likewise, he will continue to introduce reforms that follow free market principles by requiring price transparency from all health care providers, allowing the importation of prescription drugs from foreign countries and allowing insurance companies to sell their policies across state lines, which would expand competition in many states and open up the market for smaller, regional insurance companies.
In an effort to reduce the cost of health care, he would allow individuals to fully deduct premium payments on their tax returns, encourage the adoption of High Deductible Health Plans and allow expanded use of Health Savings Accounts, which he would allow to be passed on to future generations without a tax penalty. Additionally, he would aim to reform Medicaid, only permit legal citizens to participate in state or federal health care exchanges, and he would take steps to reform mental health programs and institutions.
Should Trump be unsuccessful in reforming the ACA, he will move forward with eliminating the individual mandate, which would begin the slow unraveling of the ACA.
What's the biggest difference in each proposal?
When one looks at the reforms proposed by each candidate, it becomes clear that there are fundamental differences. But I think the starkest difference is in how reform is positioned. Clinton is advocating a continuation of the ACA, and all of her solutions are government in nature. Trump, on the other hand, is offering free market answers. He minimizes government involvement, except to the extent of Medicaid and Medicare. Health care consumers and brokers need to do all they can to educate themselves on each candidates’ positions before taking to the polls later this year.