The Affordable Care Act is now the law of the land granting health care to millions of Americans who lacked coverage or were under-insured. While the Democrats want to expand “Obamacare,” the Republicans have spent years trying to repeal it. This presidential election is central to figuring out if we’re a country where health care is a fundamental right or only available to those who can afford it.
The only political issue more polarizing than abortion is health care reform. Hillary Clinton’s 1994 debacle still haunts her some 20 years later; the vast majority of Donald Trump’s quotes on health care involve him railing against “Obamacare.” The two candidates have vastly different visions for the American health care system, with Hillary focusing on expanding federal programs, and Trump wanting to reduce dependence on them.
Hillary has been battling for affordable health care for years. While her push for universal health care — dubbed “Hillarycare” — stymied and ultimately died in 1994, severely affecting her popularity, she kept up the fight, supporting Barack Obama’s Affordable Care Act (Obamacare). If elected president, she promises “universal, quality, affordable health care for everyone in America.” In January, she said, “I’ll defend the Affordable Care Act — and go even further to reduce costs. My plan will crack down on drug companies charging excessive prices, slow the growth of out-of-pocket costs, and provide a new credit to those facing high health expenses.” These ideas will see her facing down the same pharmaceutical companies that helped kill her 1994 health care plan.
She promises to “protect consumers from unjustified prescription drug price increases from companies that market long-standing, life-saving treatments and face little or no competition.” This would include drugs like Mylan’s EpiPen, and diabetics’ life-saving insulin.
Hillary’s plan also includes provisions to help the marginalized: the rural, the poor, and the undocumented. She plans to incentivize states to increase Medicaid, which would help the lowest-income Americans. Expanding access to rural America would also provide more people with health care by easing telehealth reimbursement through Medicaid. And she says, “I … want to see that we have more options for the undocumented to get the care that they need.” Families would be allowed to buy insurance on the health care exchanges “regardless of immigration status.”
She would protect women’s reproductive health care, including access to safe abortion and contraception, and assure that, as she said in February, “If you are a woman, for the first time, you don’t pay more for your health care than men.”
On the other hand, Trump’s health care plan relies on immediately repealing the Affordable Care Act (Obamacare) that provides coverage to 20 million Americans, eliminates lifetime caps on care reimbursement, and bars the idea of preexisting conditions. Last September, Trump said, “Obamacare. We’re going to repeal it, we’re going to replace it, get something great. Repeal it, replace it, get something great!”
Other reforms rest on the idea that if we throw up our hands and let the free market decide, everything’s gonna be all right. We need to allow the sale of health insurance across state lines, allow people to deduct premiums from their taxes, and let people use HSA (health savings accounts), which would accumulate and could be passed down without any “death taxes.” Trump would require “price transparency” from health-care providers, so people could pick the best rates, and block-grant Medicaid (i.e., hand things to the states rather than the federal government, continuing the GOP principle of states’ rights). Trump would also “remove barriers to entry into the free markets for drug providers that offer safe, reliable, and cheaper products.”
In stark contrast to Hillary Clinton, he rails against “illegal immigrants” who he says cost America 11 billion in health insurance costs per year. One cornerstone of his health insurance plan, then, is to “enforce existing immigration laws.” To drop the number of people needing Medicaid — rather than expanding it, like Clinton — he claims we need “to install programs that bring capital and jobs back to America.” “The best social program,” he says, “has always been a job — and taking care of our economy will go a long way towards reducing our dependence on public health programs.” These economic reforms include not direct job creation, but reducing taxes, killing (“reviewing and reforming”) regulations on things like the Clean Water and Air Act, and trade reform (including renegotiating NAFTA and labeling China a currency manipulator).
Trump and Clinton both agree on the need for mental health care reform, and say so in their platforms.