Wednesday, September 7, 2016

How the 2016 Presidential Election Could Impact Healthcare in America

This presidential election could bring some changes to the U.S. healthcare system.  As with all candidates in recent history, both of the two major party nominees have given lip service to controlling health care spending and reducing out-of-pocket expenses. 

Clearly, the Cadillac Tax appears to be doomed as both Hillary Clinton (D) and Donald Trump (R) support its repeal.  Even President Obama and our current congress have no desire to actually unleash that tax on Americans as evidenced by its original start date in 2018 (a full eight years after Obamacare was signed into law) and the recent delay to 2020.

The chart below provides a brief overview of each candidate’s proposed healthcare solutions:

Hillary Clinton (D)
Donald Trump (R)
PPACA (Health Reform Law)
Wants to expand PPACA
Wants to repeal PPACA
Cadillac Tax
Wants to repeal it
Wants to repeal it
Prescription Drugs
Supports elimination of tax breaks drug makers receive for direct-to-consumer advertising and supports allowing consumers to buy Rx from other countries
Supports freeing-up the market in prescription drugs with a reduction in some regulation and favors allowing consumers to buy Rx from other countries
Undocumented persons’ access to taxpayer subsidized healthcare
Would allow undocumented persons’ to buy healthcare in the PPACA Exchanges
Wants potential immigrants to prove they can pay for their own healthcare
Medicare for all
Would allow persons as young as 55 to buy into Medicare coverage
Has not stated support for this concept at this time
Coverage Across State Lines
Is open to allowing the sale of insurance policies across state lines but that is not officially part of the Democratic party platform
Would allow the sale of health insurance policies across state lines for both individuals and businesses
End of Tax Deduction Discrimination against Individuals (in favor of Businesses)
Unknown, but not currently part of the Democratic party platform
Would allow individuals who buy health insurance plans to deduct those costs, a provision that is solely reserved for businesses
Consumer Driven Healthplans (HRAs and HSAs)
Supports more transparency in healthcare but not necessarily greater use of consumer driven plans
Encourages the expansion of transparency and consumerism in healthcare via greater use of HSAs and HRAs
Would further expand Medicaid by having the federal government cover 100% of a state’s cost for such expansion over the next three years
Would not expand Medicaid, but instead would block grant federal Medicaid dollars to the states to allow them to manage each of their programs and budgets as they see fit
Expansion of PPACA “Affordability” Test for Dependents
Has expressed revisiting this issue to possibility redefine employer plan “affordability” to include some form of employer contribution for an employee’s dependents

Does not support the expansion of PPACA affordability standards for employers
Expansion of PPACA “Affordability” Test for Individuals
Would increase tax subsidies by lowering the maximum percentage of income that makes persons eligible for premium subsidies to 8.5%, from the current 9.5%
Does not support the expansion of PPACA affordability standards for individuals
Premium Price Controls
Would not empower the federal government to block or modify carrier premium increases

Of course, whether these platforms are achieved once one of the candidates is in office remains to be seen. Despite similar ambitions no president from either party has achieved goal of healthcare cost containment in modern history. At least with this chart, however, you can better understand how each candidate will attempt to tackle the problem.