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Trump vs. Clinton

Positions on Healthcare

What follows is an overview of the key distinctions between Trumpcare and Clintoncare, that is, each candidate’s views on the main issues/topics pertaining to health insurance.

 

Overview on Healthcare

Donald Trump

 

Seeks to repeal the Affordable Care Act, but wants to keep parts of it, including the pre-existing condition exclusion.

Hillary Clinton

 

Wants to build on the success of the ACA. Does not want to repeal it.

What does he mean?
Trump wants to repeal the ACA, but likes some parts of it, including the pre-existing condition provision. Further, he has stated he does not want people to “die in the streets,” suggesting he supports some kind of free or low-cost public health option.

What does she mean?
Clinton supports the ACA, but has indicated she will make changes to it. For example, she has repeatedly urged Congress to repeal the Cadillac tax and has proposed modifications to lower out-of-pocket costs and increase access to pharmaceutical drugs. 1

Cadillac Tax

Donald Trump

 

Wants to repeal it.

Hillary Clinton

 

Wants to repeal it.

What do they mean?
Both Trump and Clinton would repeal the Cadillac tax.2

The Cadillac Tax is set to start in 2020. It is an excise tax of 40% on the cost of health coverage exceeding the threshold value of $10,200 for individual coverage and $27,500 for a family. It is considered a major funding vehicle for the Affordable Care Act. 3

Cost of Coverage

Donald Trump

 

It’s too high right now and it needs to go down.

Hillary Clinton

 

It’s too high right now and it needs to go down.

What do they mean?
Both candidates have said they would like to see the cost of coverage go down. Trump’s proposed plan seeks to increase consumer choice, provide individual tax relief for health insurance and keep plans portable and affordable. He also seeks to break health insurance company monopolies and allow individuals to buy insurance across state lines.

Clinton has also argued against health insurance monopolies and has published a comprehensive plan for reducing out-of-pocket health insurance costs.4

Prescription Drugs

Donald Trump

 

Prices need to go down.

Hillary Clinton

 

Prices need to go down.

What do they mean?
Both candidates have stated they would like to see the costs of pharmaceutical drugs go down, but each, for the most part, has a different approach. Both Trump and Clinton support allowing government-run Medicare to set drug prices to reduce the growth in healthcare costs.5

Insurer Consolidation

Donald Trump

 

Opposes it.

Hillary Clinton

 

Opposes it.

What do they mean?
Both candidates oppose the trend of insurer consolidation/increased mergers/insurer monopolies.6

There have been several proposed mergers of large insurers in recent months (e.g., Humana and Aetna). The candidates have expressed concern that this will lead to fewer options for consumers. The companies have stated that merging will enable them to lower prices for consumers.

Provider Transparency

Donald Trump

 

Yes.

Hillary Clinton

 

Yes.

What do they mean?
Both candidates have urged for greater healthcare provider transparency7 in order to help consumers make more informed choices.

Clinton specifically has mentioned the need to end “surprise” medical bills that occur, for instance, when a patient visits an in-network facility and unwittingly receives services from a doctor who is not part of their network and ends up with steep bills.

Consumer-Driven Healthcare

Donald Trump

 

Strongly supports.

Hillary Clinton

 

Not a major healthcare policy initiative.

What does he mean?
Trump supports CDHPs. His proposed healthcare plan calls for tax-free HSAs and greater access and portability of CDHPs. 8

What does she mean?
Clinton has not expanded on this initiative.

Purchasing Insurance Across State Lines

Donald Trump

 

Yes.

Hillary Clinton

 

Not discussed.

What do they mean?
This is a major policy initiative of Trump.9 It has not been addressed by Clinton on the campaign trail.

States currently set their own regulations for insurance and establish their own requirements. These existing laws inhibit interstate sales of health insurance. Trump proposes to modify these laws in an effort to increase competition.

Medicare-for-All/Single-Payer Solution

Donald Trump

 

While Trump would repeal the ACA, he has made comments suggesting he would be open to some kind of free healthcare option or single-payer system.

Hillary Clinton

 

Prefers the ACA model over a single-payer model.

What do they mean?
These candidate views were discussed during the primary debates.10

Donald Trump Campaign Website, “Healthcare Reform to Make America Great Again” and “Trump’s Seven-point Healthcare Plan”; Ballotpedia, “Presidential Elections: The Road to the Whitehouse; Forbes, “On ’60 Minutes,’ Donald Trump Says Obamacare Is A Disaster, But His Own Plan Is Even Worse”; Wall Street Journal, “Trump’s Halfway Healthcare Reform”; Slate, “Donald Trump’s Terrific, Inexpensive Health Care Plan Is the Same as Every Other GOP Plan
Politico, “Hillary Clinton: Kill Obama’s ‘Cadillac Tax
The Wall Street Journal, Q&A: What is the Cadillac Tax and Why Is It In Trouble?
Forbes, “Donald Trump Hates Obamacare, So I Asked Him How He’d Replace It”; U.S. News & World Report, Clinton Proposes a Series of Steps to Curb High Out-Of-Pocket Healthcare Costs
US News & World Report, “Not Up for Negotiation: Lowering Drug Prices Is Much More Complicated Than the Candidates Make It Sound
Hillary Clinton Campaign Site, “Serious Concerns’ About Proposed Mega-Mergers of Health Insurance Companies”; Time, “Hillary Clinton Targets Health Insurer Mega-Mergers
Wall Street Journal, “Donald Trump Releases Healthcare Plan”; Politico, “Hillary Clinton Pivots to Health Care Affordability
Donald Trump Campaign Website, “Healthcare Reform to Make America Great Again
Donald Trump Campaign Website, “Healthcare Reform to Make America Great Again”; The Hill, “Health Insurance Across State Lines
10 CBS News 60 Minutes, “Donald Trump Gets Down to Business”; National Public Radio, “Hillary Clinton Hitches Her Healthcare Wagon to Obamacare