Presidential Candidates and Healthcare

The 2016 presidential election will mean changes to Affordable Care Act (ACA), and two candidates – on opposite sides of the issue – say they would eliminate employer-sponsored health benefits.

In general, the Democrats want to expand government-sponsored healthcare coverage, while Republican candidates are united in their determination to repeal “Obamacare.”

No matter who wins, you can expect employee benefit plans to undergo changes and last-minute rulings that create temporary chaos and confusion during the transition.

Here’s a snapshot of how candidates plan to improve the cost and quality of healthcare:

Hilary Clinton plans to build on the foundation set by the Affordable Care Act. An advocate for universal coverage for more than 20 years, Clinton has pledged to expand coverage for millions of Americans by:

  • Lowering premiums and out-of-pocket expenses for those buying coverage on the exchanges.
  • Encouraging Medicaid expansion with incentives to states, including a 100 percent match for three years.
  • Making enrollment easier with support from navigators and other outreach activities.
  • Supporting a “public option” in interested states.

Bernie Sanders is calling for “Medicare for all.” He wants to create a single-payor health plan, which he says will save the typical middle class family $5,000-plus, and save businesses $9,400 per employee annually.  Sanders’ plan includes:

  • Implementing a universal health plan for all medical care and treatment.
  • Eliminating provider networks— anyone could see any doctor.
  • Eliminating copays, deductibles and other out-of-pocket costs.
  • Paying for the plan with income-based health care premiums (6.2 percent from employers and 2.2 percent from households) along with changes to income tax, capital gains tax and estate taxes.

Senator Ted Cruz would have Congress repeal the Affordable Care Act. In 2013, before the law went into effect, he famously filibustered for an historic 21 hours in an effort to halt its implementation.  Cruz says he’ll make healthcare more personal, portable and affordable by:

  • Expanding the use of Health Savings Accounts to provide tax advantages.
  • Allowing individuals to purchase insurance across state lines to increase competition and drive down premiums.
  • De-linking health insurance from the workplace so Americans wouldn’t lose coverage if they change jobs or are laid off.

Ohio Governor John Kasich would repeal the Affordable Care Act.  His plan uses market-based principles to hold down costs and improve health by:

  • Expanding Medicaid.
  • Placing more emphasis on patient-centered primary care, with added incentives for providers.
  • Encouraging episode-based payments and other forms of payment reform.
  • Allowing states to control insurance market regulations.

Donald Trump also wants to repeal the Affordable Care Act, bringing “free market reforms” to the healthcare industry. Trump’s plan includes:

  • Eliminating the individual mandate.
  • Allowing health insurance sales across state lines.
  • Allowing individuals to deduct health insurance premium payments on their tax returns.
  • Expanding the use of Health Savings Accounts.
  • Requiring price transparency for doctors and healthcare organizations.
  • Providing Medicaid block-grants to states.
  • Driving down prescription drug prices by allowing consumers to buy drugs from other countries.
  • Whether this becomes a tornado or a tsunami in the world of employer benefits depends largely on which candidate is elected, how much cooperation comes from Congress, and the inevitable challenges and decisions at the Supreme Court level.
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