Category Archives: Election 2016: The Presidential Candidates and Health Care

The Affordable Care Act 2.0: Hillary’s Plan for Obamacare

In the last several Fontenotes I have been reviewing each Presidential candidate’s platform on healthcare.

To date I have reviewed Bernie’s Single-Payer proposal, Trump’s platform (and statements he has made over time that is the basis of some confusion about his vision), and John Kasich’s plan to repeal the ACA upon election.

I did not have an opportunity to review Ted Cruz’s position on health care before he suspended his race, but as his website did not list healthcare as an issue it is sufficient to say he had promised repeatedly to repeal the ACA on his first day in office.

The last current candidate’s health care stance to review is that of Hillary Clinton. As the only candidate that has vowed to “protect the Affordable Care Act,” it is important to also look at how she would reform the law if she becomes president.

Hillary’s Platform [and Some Explanations]

As explained on her website,  “Hillary will to continue to defend the Affordable Care Act (ACA) against Republican efforts to repeal it. She’ll build on it to expand affordable coverage, slow the growth of overall health care costs (including prescription drugs), and make it possible for providers to deliver the very best care to patients.”

Specifically, she proposes to:

  • provide a tax credit of up to $5,000 per family on the ACA exchanges to offset a portion of excessive out-of-pocket and premium costs above 5% of their income. [As described in more detail on another campaign website, this would be a new refundable tax credit of up to $2,500 for an individual, or $5,000 for a family, available to those with substantial out-of-pocket health care costs. The credit will be available to insured Americans with qualifying out-of-pocket health expenses in excess of 5% of their income, and who are not eligible for Medicare or claiming existing deductions for medical costs. “This refundable, progressive credit will help middle-class Americans who may not benefit as much from currently-available deductions for medical expenses”];
  • limit the cost of premiums for families on the exchanges to 8.5% of their income [currently, premiums may consume up to 9.5% of your Modified Gross Income];
  • fix the “family glitch” [“the most glaring defect” in the ACA subsidy design, if a family member is offered “affordable insurance” through a family member’s employer, they cannot purchase insurance separately on the exchanges. This leaves many people locked out of the exchanges while also not being able to afford the plan theoretically offered to them.]
  • lowering prescription drug costs [for more details, Hillary’s plan for doing this is explained here];
  • continue incentives to continue to increase the number of states that expand Medicaid [these were initiated in January by President Obama, as described in Fontenotes #14]
  • dedicate more funding for outreach and enrollment efforts to increase the number of eligible people that apply for coverage under the ACA;
  • allow everyone, including families not in the country legally, to purchase coverage on the ACA exchanges;
  • continue to support a “public option” [allowing the government to offer plans similar to Medicare on the exchanges, competing with private insurance policies and (presumably) decreasing costs through competition. For an extensive review of the origin and demise of the public option as part of the original ACA legislation go here];
  • support and protect access to women’s health services, including contraception and safe, legal abortion;
  • continue efforts to reimburse healthcare based on the quality, not just the quantity, of care delivered;
  • increase telemedicine to increase access to care in rural America.

All of these points are described in greater detail on the Hillary Clinton Campaign website.

Where Do We Go From Here?

Assuming that she could achieve all of the above if she becomes President (which is not a small assumption given the current state of Congress) the ACA would, undoubtedly, change under Hillary Clinton’s proposed reboot.

But whether these changes are improvements or more bad ideas depends, of course, on your personal opinion of the Affordable Care Act itself.

There are also many questions raised collectively by all of the Candidate’s platforms that require further attention. What would happen if the ACA was completely repealed? How can costs be controlled, regardless of the law? Are high-deductible policies here to stay? And how can the government intervene in the escalating drug costs that are hurting so many people? These are all questions that will be addressed in future Fontenotes.

But in the meantime, I do hope this series has helped you review all the different health care initiatives floating in this important election- and has assisted you in making a decision about how you- as a health care consumer- want to vote in November.

Want to Know More?

This completes the Fontenotes Presidential Candidate series. For those of you who want to review the remaining candidates’ healthcare platforms on your own, here are their websites:

Bernie Sanders

Donald Trump