Posted March 29, 2016
The 2016 presidential candidate field has narrowed, with two Democrats and three Republicans remaining. As the race tightens, the presidential candidates’ beliefs about the U.S. health care system and how to change it are in the spotlight.
Here’s an overview:
Survey of Americans
Kaiser Family Foundation commissioned a health tracking poll in February. The results and political party affiliation are listed below:
- 16% believe the Affordable Care Act should be repealed and NOT replaced (8% Democrats, 12% Independents, 26% Republicans)
- 13% said the ACA should be repealed and replaced with a Republican-sponsored alternative (1% Democrats, 13% Independents, 34% Republicans)
- 36% want lawmakers to build on the existing health care law to improve affordability and access to care (54% Democrats, 36% Independents, 21% Republicans)
- 24% would like guaranteed universal coverage through a single government plan (33% Democrats, 26% Independents, 9% Republicans)
Rhode Island public radio recently developed an overview of the presidential hopefuls positions on health care. Here are the key points, organized in alphabetical order:
Hillary Clinton (D) – She defends the value of the Affordable Care Act. Instead of repealing it, Clinton wants to lower costs of prescription drugs and increase support for women’s reproductive health care.
- Reduce premium costs and deductibles – Clinton wants to assist Americans in buying health care insurance through an exchange with a tax credit up to $5,000/family, after spending 5% of their annual salary on deductibles and premiums. According to the report, someone making $75,000 yearly would have to pay at least $3,750 out of pocket before getting relief.
- Public option – Clinton also supports a public option for health care, described as a government-run health insurance system that covers everyone. It would be a single federal plan that would compete against private insurance companies. This may be a viable option for many Americans who don’t have insurance or cannot afford it.
Ted Cruz (R) – In campaign advertising and at Republican debates, Cruz has affirmed his plan to abolish the Affordable Care Act. He also wants to:
- allow insurance companies to sell policies across state lines
- expand Health Savings Accounts
- delink health insurance from employment; more information is needed to clarify whether this means having employees purchase insurance benefits separately from employers, or participate in a government-funded plan
John Kasich (R) – The Affordable Care Act is the wrong diagnosis and must be repealed and replaced, Kasich states. Although access to affordable health insurance is vital, the current plan fails to achieve this goal as premiums continue to increase. Kasich also says many Americans receive more care and not better care.
- He cites the example of fee-for-service plans, which create incentives for health care providers to perform more tests and services for patients instead of identifying ways to keep them healthy.
- In comparison, about 55% of Americans don’t get preventive care screenings or assistance with managing chronic health problems. Kasich supports rewarding value instead of volume of care.
Bernie Sanders (D) – He is promoting universal health care and Medicare for everyone. This plan would extend health care coverage to 30 million Americans currently without insurance. Sanders embraces a single-payer system, similar to coverage in Canada and many European countries.
- Americans would pay only a yearly tax for health care services, eliminating the need for deductibles and co-payments. The price tag for free care would be about $1.38 trillion.
- Sanders proposes covering this expense through a tax on businesses and individuals, and eliminating some tax breaks for health care companies. He projects the plan would save money on health care costs, especially since the U.S. spends nearly $3 trillion annually on health care.
Donald Trump (R) – He wants to completely repeal the Affordable Care Act and eliminate the individual mandate for health insurance. He does not the support having a single-payer insurance system.
- Instead, Americans should be able to buy insurance coverage from any carrier in any state. He also supports requiring price transparency for all health care providers, so all costs are shared with patients before services are provided.
- Trump also supports the use of Health Savings Accounts to assist Americans in paying for medical expenses not covered by insurance.