Trump and Biden on Health Care
https://jamanetwork.com/channels/health-forum/fullarticle/2770427?resultClick=1
The Affordable Care Act:
· Trump: Repeal it; persuade the Supreme Court to declare it unconstitutional. “I have a better plan in my mind.” He says he wants to retain the ban on pre-existing coverage exclusions by insurers, but has not released any plan to do so.
· Biden: Build on it to cover the low income uninsured in the non-participating Southern and Great Plains states using Medicare and increase premium assistance to moderate and middle income in the Exchanges. Would use the “public option” i.e. Medicare like coverage for the low-income uninsured in non-participating states and also make it available in the Exchanges.
Medicaid:
· Trump: Repeal the Medicaid expansion for the working poor. Make it a block grant. Apply work requirements to families. In other words, we want you to work and want to take away your health coverage if you are working — somewhat contradictory messages.
· Biden: Increase the federal matching to states during the Covid Recession. Cover the low income uninsured through the public option in the 18 states that have not yet agreed to expand Medicaid coverage to the working poor.
Medicare
· Trump: Increase enrollment in private insurance Medicare Advantage plans, there are no concrete proposals.
· Biden: Expand eligibility for those aged 60-64. Add dental, vision and hearing services. Use as foundation for “public option” to be offered in the Exchanges and Medicaid.
Prescription Drugs
· Trump: Supports caps on out of pocket, importation of prescription drugs and international reference pricing.
· Biden: Medicare would negotiate drug prices using international reference pricing, supports importation of prescription drugs.
Surprise Medical Bills
· Trump: Supports a ban on surprise medical bills, no details.
· Biden: Supports a ban on surprise medical bills, no details.
Reproductive Health
· Trump: Reverse Roe v. Wade, defund Planned Parenthood, allow employers to deny contraceptive coverage for their employees, reinstated the Mexico City policy denying international assistance for organizations that perform or support abortions.
· Biden: Supports Roe v. Wade, wants to overturn the Hyde Amendment restrictions on Medicaid coverage for abortions, restore employee coverage for contraceptive services, would repeal Trump’s reinstatement of the “Mexico City Policy”.
Covid 19
· Trump: Primary responsibility rests with the states, denigrates mask wearing and social distancing. Has pushed hard for vaccine development and for both proven and unproven potential treatments.
· Biden: Primary responsibility rests with the federal government, would encourage mask wearing and social distancing. Increase funding for testing, contact tracing, and personal protective equipment for health care workers. Subsidize COBRA premiums for those employees experiencing job loss or furloughs due to Covid 19.
The Committee for a Responsible Federal Government projects the Biden plans would add $850 billion (mid range estimate) to the federal budget deficit over the next decade. It would cover an additional 15-20 million uninsured Americans. http://www.crfb.org/papers/understanding-joe-bidens-2020-health-care-plan
Under the Trump proposals, 30 million Americans will lose existing health coverage. https://www.epi.org/aca-obamacare-repeal-impact/ Some of the very worst impacts (on a per capita basis) are in Kentucky, West Virginia, Arkansas, Montana, Michigan, New Hampshire and Louisiana.
Vote early and vote Joe Biden for your health.
Lucien Wulsin
Dated: 10/26/20