Where Trump and Clinton Stand on Health Care Issues
October 17, 2016 03:08 PM
Last week NAHC Report covered the positions the two major presidential candidates, Republican Donald Trump and Democrat Hillary Clinton, have taken on long-term care issues. Today, we will cover health care generally, by looking at how Clinton and Trump promise to maintain or alter America’s gigantic health care system.
Before we begin, it should be noted that the Clinton health care manifesto is considerably larger and more detailed than what the Trump campaign has made available. Where we can find no comment on a particular health care issue from the Trump campaign, we will simply note that.
As before, this article is not meant to serve as any form of voting or political advocacy; it is intended solely for the purpose of providing information to our readers.
Affordable Care Act
A long-time believer in government action to expand health care access, Clinton promises to maintain the ACA and even expand it. Clinton supports fixing the problems that have clearly arisen in the ACA – such as insurers fleeing the exchanges – without dismantling the basic structure of the law.
On the other side, Trump vows to completely repeal the ACA. He promises to replace it with something excellent, but has given few specifics.
"What we are going to do is we're going to save Medicare, we're going to save Social Security, we are not going to raise the age, and we're not going to do all the things that everyone else is talking about doing, said Donald Trump at a campaign rally in 2015. “They are all talking about doing it and you don't have to." Trump’s plan is to maintain Medicare through increased economic growth and elimination of waste, fraud and abuse. Trump would also allow Medicare to negotiate prescription drug prices, a measure that would save a considerable amount of money, though perhaps not the $300 billion Trump is promising.
Clinton would also allow Medicare to negotiate prescription drug prices, but she would also demand higher rebates for low-income recipients. The Clinton campaign estimates this would save more than $100 billion in Medicare costs.
In addition, Clinton would allow people age 55-64 to buy in to Medicare. She would also expand the value-based delivery system reform in Medicare and Medicaid.
Clinton would allow Americans to import drugs from countries with safety standards as robust as those in the United States. She would also require health insurance plans to place a $250 monthly limit on covered out of pocket prescription drug costs for individuals. Finally, Clinton would increase the availability of generic drugs by prohibiting “pay-for-delay” deals and lowering the biologic exclusivity period from 12 to seven years. The FDA would be directed to give priority and expedited reviews to drugs with only one or two competitors in the marketplace.
Trump’s prescription drug plan is not as detailed, but he would allow consumers to purchase imported drugs if those drugs were demonstrated to be safe.
Trump promises to follow through on a long-held belief of the Republican party to transform Medicaid into a block grant to states.
By contrast, Clinton would maintain Medicaid financing as it is, but would also encourage states to adopt the Medicaid expansion by allowing any state that expands Medicaid to receive a 100 percent federal match for the adult population for the first three years.
Clinton would cooperate with state governments to establish public option plans, repeal the “Cadillac tax,” fix the “family glitch,” and allow the Department of Health and Human Services to modify or block unreasonable health insurance rate increases in states lacking such authority. Finally, Clinton would increase premium tax credits so individuals and families pay a maximum of 8.5 percent of their income on health insurance premiums.
Clinton promises to require plans to provide three sick visits per year that do not count towards deductibles. She would ensure that people do not have to pay more than in-network cost-sharing for care received in a hospital that is in their plan’s network.
Clinton would require employers, insurers and providers to make public more information about out-of-pocket costs, drug costs, doctor networks and more. She would also allow all families, regardless of their immigration status, to buy insurance through the Health Insurance Marketplaces.
Trump would allow people to buy insurance across state lines, allow tax deductible health care premium payments and establish high-risk pools for people in the states who have not maintained their coverage. He would also allow people to enroll in tax-free Health Savings Accounts to pay out-of-pocket costs and require price transparency from all health care providers.
The Trump campaign promises to defund Planned Parenthood, make the Hyde Amendment permanent and oppose all abortions except those to save the life of the woman or in cases of rape or incest.
Clinton would repeal the Hyde Amendment; oppose any defunding of Planned Parenthood and efforts to restrict access to abortion or contraception.