Presidential Candidate Healthcare Coverage Proposals Target Prescription Drug Pricing

Potential healthcare reforms from Hillary Clinton and Donald Trump wildly diverge in how they will address the Affordable Care Act.

The presumptive US Presidential candidate nominees, former Secretary of State Hillary Clinton and Donald Trump, both have very different healthcare proposals that will no doubt be challenged by an aging population and rising costs.

Clinton plans to expand the Affordable Care Act (ACA) by increasing Medicaid and insurance subsidy spending, according to a report by the Committee for a Responsible Federal Budget. She also proposed decreased prescription drug spending for Medicare.

Trump seeks to replace the ACA and block grant Medicaid, which would result in reduced subsidy costs; however, it would also increase Medicaid costs due to ACA cuts, according to the report.

Hillary Clinton Health Policy

The presumptive Democratic nominee Clinton plans to offer federal funds to states wishing to expand Medicaid to enable new enrollees to be fully covered in the first 3 years of expansion, which similar to the policy currently in place. An additional $500 million per year will be spent to reach out to people who are eligible for Medicaid or subsidies, but have not signed up, according to the report.

She also plans to expand insurance subsidies by limiting out-of-pocket (OOP) costs, and will create a tax credit to cover OOP costs above 5% of income. Repealing the Cadillac Tax, a 40% excise tax paid by high cost employer plans, is also part of Clinton’s proposal.

This tax has recently been delayed by Congress to start in 2020.

To combat rising drug costs, Clinton will require drug manufacturers to lower Medicare Part D prices. She also will encourage states to start a “public option” in insurance marketplaces and pursue payment reforms.

Lastly, Clinton proposes to stop drug manufacturers from deducting advertising costs from their taxes in an effort to decrease the amount of advertising. The remaining advertisements would have to be approved by a newly-created FDA program.

Donald Trump Health Policy

Presumptive GOP nominee Trump’s proposed health policies would cost approximately $50 billion, but could potentially cost as much as $550 billion and save as much as $850 billion, according to the report.

Trump’s repeal of the ACA would translate to a $1.65 trillion spending reduction, but would also eliminate $950 billion of Medicare savings and $1.2 trillion in revenue increases, according to the report. The repeal could also potentially promote economic growth as well, the report noted.

Trump proposes to create more equality for tax deductions among individually-purchased plans and employer-provided health insurance. He also endorses the use of Health Savings Accounts.

Trump would allow the importing of drugs from other countries, and would allow people to buy health insurance across state lines as long as the insurance company complies with the state laws.

Price transparency is also supported by Trump. He also states that Medicare should negotiate prices with drug companies, although the report estimates this will translate to little in savings.

The block-grant funding for Medicaid would allow states to determine how the funds should be spent. Since no details have been given, this policy could potentially save money or it could increase federal costs.

Though very different in how they plan to enact change, it is clear that both candidates are targeting significant reform to the healthcare system in the United States.