Policy and Regulation News

Presidential Election Brings Two Opposing Healthcare Policy Proposals

The healthcare policy proposals from the Democratic and Republican side with regard to the presidential election center on whether or not the Affordable Care Act will be repealed.

By Vera Gruessner

With the Presidential election heating up and the debate season upon us, last week The Commonwealth Fund detailed the stark differences seen between the two presidential candidates healthcare policy proposals in a new report. The research comes from Christine Eibner and colleagues at the RAND Corporation, which reached out to both campaigns to gather information regarding both the GOP and democratic healthcare policy proposals.

Affordable Care Act

The two positions on healthcare reform are nearly opposites when considering health insurance coverage, out-of-pocket costs, and effects on the federal budget. First, the two sides have differing opinions on how to handle the Patient Protection and Affordable Care Act. Republican Presidential nominee Donald Trump is looking to repeal the Affordable Care Act while former Secretary of State and Democratic Presidential Nominee Hillary Clinton is seeking to bolster and maintain the Affordable Care Act.

The healthcare policy proposals from the Clinton camp are looking to bring more enhancements for the Affordable Care Act while the GOP has previously announced replacement plans if the ACA was to be repealed such as allowing health plans to be sold across state lines.

A complete repeal of the Affordable Care Act would lead to eliminating health insurance subsidies and the state exchanges, Medicaid expansion reforms, and more minute reforms of the ACA such as banning the use of pre-existing condition clauses. This may mean that health payers could again refuse to provide coverage to patients who seek insurance after a serious diagnosis. Additionally, a repeal of the ACA would lead to approximately 20 million Americans to lose their healthcare coverage.

The Commonwealth Fund report also stated that a repeal of the law would lead to an increase in the federal deficit and a rise in average premium and out-of-pocket costs. The reason for the rise in the federal deficit would be due to a reduction in Medicare reforms and the fees and taxes that the Affordable Care Act generated for the nation’s federal budget.

When not taking any replacements or enhancements to the repeal or maintenance of the ACA into account, the results show either a $0 effect on the deficit or a $33.1 billion increase in the deficit when the ACA is repealed. Average out-of-pocket costs in the individual market would also increase $1,500 to $4,700 if the Affordable Care Act was to be repealed.

However, healthcare policy proposals from the Democratic Presidential Candidate Hillary Clinton also show that the federal deficit would increase under three specific positions, according to the report. These healthcare policy proposals aim to reduce consumers’ out-of-pocket costs for premiums and medical care. Clinton has proposed to pay for these healthcare policies through rebates of drug manufacturing companies and via taxes on high-income individuals.

“These policies would increase the number of insured individuals by 400,000 to 9.6 million, and decrease consumers’ health spending relative to current law,” an issue brief from The Commonwealth Fund states. “Cost-sharing tax credits have the biggest effect—increasing coverage by 9.6 million and decreasing average spending by up to 33 percent for those with moderately low incomes. However, the policies with the largest coverage gains also increase the federal deficit, with impacts ranging from –$0.7 billion to $90 billion.”

There are a few ways in which the healthcare policy proposals from Donald Trump and Hillary Clinton are actually closer in similarity. Both presidential candidates have shown concern for the growth in prescription drug prices and have advised greater competition within the pharmaceutical industry and enabling patients to buy drugs overseas.

Clinton has also proposed putting caps on prescription drug out-of-pocket costs. Additionally, both Clinton and Trump have called for greater price transparency among doctors’ offices and hospitals.

“As your president, I want to build on the progress we’ve made. I’ll do more to bring down health care costs for families, ease burdens on small businesses, and make sure consumers have the choices they deserve. And frankly, it is finally time for us to deal with the skyrocketing out-of-pocket health costs, and particularly runaway prescription drug prices,” Clinton said in a public statement.

At the beginning of this summer, House Speaker Paul Ryan released a replacement plan that the Republican Party put together if the Affordable Care Act was to be repealed. The report from The Commonwealth Fund aligns with the continual push from the GOP to repeal the ACA.

The replacement plan emphasized risk pools and health savings accounts as well as the option to raise the Medicare eligibility age to 67, but had few financial details on how this new health coverage plan would be funded.

The two healthcare policy proposals from the opposing sides could change the health insurance market and costs consumers face significantly. The future for healthcare coverage will depend upon the outcome of the Presidential election this November.

Image Credits: The Commonwealth Fund

 

Dig Deeper:

How the Affordable Care Act Changed the Face of Health Insurance

How Payers Could Succeed in ACA Health Insurance Exchanges