Although it’s been harder than normal to keep track of each candidate’s policy proposals this election cycle due to all of the surrounding drama, there are substantial differences in what each is proposing that are worth considering. It can all be boiled down to the idea that President Trump would like to reduce the federal government’s role in health care while Joe Biden would like to expand the federal government’s role. While that’s easy enough to understand, it is more nuanced and when it comes to healthcare, the differences are especially important.
Note: This article was written by Max Gottlieb, senior content manager from Senior Planning.
Just as he was in the 2016 election, President Trump ran on the promise that in this term, he would be dismantling the Affordable Care Act (ACA). Whether or not this will happen seems to have been answered with a solid Biden victory. Unlike 2016 though, Trump recently signed an executive order (September 2020) launching his vision for healthcare, which supporters are saying shows his future blueprint. Most notably, Trump’s executive order protects people with pre-existing conditions. While this is good news, it is something that is already guaranteed under the Affordable Care Act so it isn’t necessarily changing anything.
The reason it is noteworthy though is because if the Supreme Court overturns the Affordable Care Act, as Trump has said they will, then his executive order will not be strong enough to protect Americans with pre-existing conditions. Because of this, many critics are saying the executive order is simply meant to boost his campaign rather than provide an actual healthcare solution. According to Katherine Hempstead, a senior policy adviser with the nonpartisan Robert Wood Johnson Foundation, “executive orders issued close to elections are not the same thing as actual policies.”
Beyond protecting people with pre-existing conditions, President Trump’s executive order also seeks to lower medication costs, limit surprise billing for patients receiving out-of-network care, end HIV by 2030, and lower Medicare Advantage premiums. Follow the link to see the Executive Order in its entirety. This all sounds great, but again, an executive order does not make something into law or actually create an actionable plan. Under Obama, with the passing of the Affordable Care Act, Congress wrote legislation that passed into law. If Trump could get Congress to turn his executive order into law, we would be having a different conversation. Although his proposal would reduce cost for Medicare consumers, there is nothing in his order to expand coverage for people.
The reason I bring up coverage is because unlike 2016, many Americans feel we need expanded coverage now more than ever due the ongoing pandemic. Due to the unprecedented health crisis, millions of Americans are unemployed. Unemployment inevitably means more Americans are uninsured than they were four years ago since many people rely on their employer for health coverage. 41 states have seen increases in their uninsured residents. This is where Joe Biden’s plan aims to step in.
As a first step to increasing coverage for more Americans, Joe Biden would like to reduce the eligibility age for Medicare from 65 to 60. For those not in that age group, Biden has also proposed a public health insurance option for coverage through the healthcare exchange. Like the current setup, plans and prices would change based on different income brackets. Although the two candidates don’t agree on much, like Trump, Joe Biden is also proposing a plan to reduce prescription drug costs.
The problem with Biden’s plan, however, is that due to the pandemic and unemployment, there will be heavy pressure to fund Medicare due to the decreased revenue coming in. Some experts even warn that the funds which make up Medicare Part A (which covers hospital visits) could be completely depleted within the decade. To prevent this, the next president will have to organize congress to create a longstanding plan of action.
The Supreme Court just heard a case regarding the Affordable Care Act, and although many predict the Affordable Care Act will not be overturned, increasing its reach will prove difficult if that is truly what Joe Biden is seeking to do. Regardless of who the next president is, he will have to come up with a healthcare solution in the very near future. Trump’s plan of dismantling the ACA without a backup plan is reckless at best. If Trump wins re-election, he will have to figure out a way to get Congress to pass his executive order into law. Even then, there are still many gaps that must be filled in before it is a feasible plan. For Biden, the main task will be convincing congress to fund his vision, which is no easy task in these bipartisan times. Either presidential candidate will have their work cut out for them should they win.
Max Gottlieb works for Senior Planning. Senior Planning helps Seniors apply for state and federal benefits to fund long term care. The process is often very complicated and Senior Planning has spent years learning the ins and outs of long term care Medicaid policy.
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