Presidential Race & Health Care Reform

Presidential Race & Health Care Reform

As the 2016 Presidential primary season heats up, the field of candidates has already shifted with several contenders suspending their campaigns and others waxing and waning in popularity.  Donald Trump has performed well in polls and won the New Hampshire primary, although Senator Ted Cruz (R-TX) continues to nip at his heels, winning the Iowa primary on February 1st. 

In addition, the Republican field of candidates got a little smaller this week as Governor Chris Christie (NJ) and Carly Fiorina suspended their campaigns. Dr. Ben Carson has struggled to regain his momentum from the Republican debates, and political insiders are still waiting for Jeb Bush’s campaign to take off.  Senator Marco Rubio (R-FL) also has continued to perform well, although he has not yet caught up with frontrunners Trump and Cruz.  Governor John Kasich (OH) may be on the verge of gaining some momentum following his second place finish at the New Hampshire primary. 

Although a smaller pool of candidates, the race is also heating up for the Democrats as Senator Bernie Sanders (D-VT) won a resounding victory over Hillary Clinton in the New Hampshire primary. Over the next five weeks, both parties will have a clearer view on their presidential candidate; although, given the course of the race thus far, it will be an interesting journey to the November general election.

For Brokers and voters in those states where primaries are scheduled, it is important to take a closer look at the candidates’ positions on health care reform.  Here is a short summary of key issues and the candidates’ positions. 

 

Issue

ACA Repeal

(Source:  NAHU)

Insurance Reforms

(Source: NAHU, unless otherwise noted)

Candidate Commentary

(Quotations and summary from  BallotPedia)

Republicans

Trump

Repeal and Replace

Promotes returning authority to the states

 

Endorses buying health insurance across state lines

 

Supports market-based competition 

At the eighth Republican presidential primary debate on February 6, 2016, Donald Trump discussed his position on healthcare, and whether it is closer to Hillary Clinton’s or Bernie Sanders’: "I think I'm closer to common sense. We are going to repeal Obamacare. ... We are going to replace Obamacare with something so much better. And there are so many examples of it.”

 

In a July 2015 Forbes interview on how Trump would replace Obamacare, a Trump spokesperson said, “Mr. Trump will be proposing a health plan that will return authority to the states and operate under free market principles. Mr. Trump’s plan will provide choice to the buyer, provide individual tax relief for health insurance and keep plans portable and affordable. The plan will break the health insurance company monopolies and allow individuals to buy across state lines.”

 

Kasich

Repeal and Replace

Supports a "managed competition" healthcare plan

 

Promoting reforms to "contain costs and improve access that does not include mandated health alliances, government cost control powers, or employer/employee mandates."

 

(Source: BallotPedia)

Kasich described the healthcare system he would like to see succeed the Affordable Care Act in an interview with NPR’s Scott Simon on July 25, 2015. Kasich said, “I'd like to replace it with a health care system that would be market-driven, that would begin to shift us to quality-based health care rather than quantity-based health care. In other words, with the primary care doctor being the shepherd to shepherd us through our health care needs, with insurance companies and hospitals working together to share profits, to share the gains they make by keeping people healthy rather than treating them on the basis of how they're sick”

Cruz

Repeal and Replace

 

Introduced Healthcare Choices Act.

Supports buying insurance across state lines

 

Opposes the single-payer health system

Cruz led a movement to defund the Affordable Care Act during a 21-hour speech on the Senate floor in September 2013.

 

“Socialized medicine is a disaster. It does not work. If you look at the countries that have imposed socialized medicine, that have put the government in charge of providing medicine, what inevitably happens is rationing. … If I'm elected president, we will repeal every word of Obamacare. And once we do that, we will adopt common sense reforms, number one, we'll allow people to purchase health insurance across state lines that will drive down prices and expand the availability of low cost catastrophic insurance.”

 

Bush

Repeal and Replace

Supports state flexibility

 

Promotes HSAs, along with cost and outcomes transparency

 

Endorses guaranteed coverage for individuals with pre-existing conditions who switch plans or move

In November 2013, Bush said that the Affordable Care Act is “flawed to its core...If the objective is, don't worry about the budget, we'll just finance it the same way we're financing our deficits right now, build a bigger debt, you could see this thing surviving. But it will have failed what the promises were. It will have failed the American people. And I don't think it will bend the cost curve."

Rubio

Repeal and Replace

Promotes high-risk pools

 

Supports purchasing across state lines,

 

Endorses HSAs

 

Opposes insurance bailouts

Rubio wrote an op-ed in Politico on August 17, 2015, detailing how to improve healthcare in the United States. After repealing the Affordable Care Act, Rubio’s plan would “create an advanceable, refundable tax credit that all Americans can use to purchase health insurance,” reform insurance regulations and transition Medicare to a premium support system.

 

In January 2013, Rubio co-sponsored S.177 - the ObamaCare Repeal Act.

 

Carson

Repeal and Replace

Promotes a form of an HSA, called Health Empowerment Accounts (HEAs)

 

Supports HSAs by giving Americans $2000/year from birth to death to spend on healthcare

 

Endorses market-based competition

At the eighth Republican presidential primary debate on February 6, 2016, Ben Carson talked about his opposition to Obamacare: “The reason that I dislike Obamacare is because the government comes in and tells the people -- which the nation is supposed to be centered on -- that we don't care what you think, this is what we're doing. And if you don't like it, too bad. That's a problem.”

Democrats

Clinton

Defend and build on

Promotes lower out-of-pocket costs, e.g. copays and deductibles.

 

Endorses three sick visits a year without counting towards deductible

 

Supports patients not paying more than in-network charges for care at hospitals in and for ER services

 

Opposes unreasonable premium increases

 

Supports $250/monthly cap on RX drugs

When asked about her greatest political regret on January 27, 2016, Hillary Clintonidentified failing to pass healthcare reform in the early 1990s. She told AOL.com, “Health care is a basic right. We are 90 percent covered, we gotta get to 100 percent, and then we gotta get cost down and make it work for everybody. And even though we didn't get it then, we've got it now and I'm going to defend it and improve it."

Sanders

Move to universal healthcare

Supports a single payer approach i.e. Medicare for all

 

Believes that private insurance companies should reduce cost by eliminating administrative waste

Sanders defended his healthcare proposal that includes “Medicare for all” again January 18, 2016, in an interview with CBS News. “If you're not one of the 29 million who doesn't have any insurance, and you have a 5,000 dollar deductible, you know what that means: When you're sick you don't go to the doctor," Sanders said. "One out of five people in this country cannot even fill the prescription that their doctor writes for them - that's called rationing.”

 

Clearly, there are some general trends emerging by both parties regarding health insurance reforms and how to best cover all Americans.  Of course, more details will be forthcoming in the weeks and months to come as we get closer to the November 2016 elections. 

Stay Tuned

Stay tuned as we continue to report on the 2016 Presidential race, emerging issues related to health care reform, and candidate proposals on matters impacting Brokers.  

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of BenefitMall. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.

 

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