The 2016 Presidential Election and the Affordable Care Act: Where do the Candidates Stand?

January 24, 2019
The 2016 Presidential Election and the Affordable Care Act: Where do the Candidates Stand?

It’s election season in America and, although it may seem like campaigning has been going on for a very long time, November 8 is rapidly approaching.  Since the Affordable Care Act (ACA) affects all employers, TriNet is taking a look at the two major party candidates to get their take on ACA and what we might expect down the road, depending on who wins the presidency and which party retains power in Congress.

Hillary and health care

According to Secretary Hillary Clinton's website if she is elected to office her plan is to “defend and expand” the ACA.  Her intention is to not only expand ACA into what she calls a “public option” but to open Medicare to those over 55 years of age.  In addition, her site refers to:

  • Bringing down the costs of copays, deductibles and other out-of-pocket costs.
  • Reducing the cost of prescription drugs.
  • A further expansion of Medicaid.
  • Exploring cost-effective ways to improve rural health (e.g., telehealth and rural health clinics).
  • Defending access to reproductive health care for women.
  • Increasing funding for community health centers.

Donald and dumping the ACA

Donald Trump's website, on the other hand, states the ACA has been an economic burden to the American people.  His site refers to “runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices.”  His intention, should he be elected, is to repeal the ACA.

To replace the ACA, Trump’s website refers to the following ideas:

  • Elimination of the individual mandate.
  • Allowing sale of insurance plans across state lines.
  • Fully deductible health insurance premiums for individuals and a review of Medicaid options.
  • An expansion of Health Savings Accounts (HSAs).
  • Pricing transparency for all healthcare providers to allow patients to shop for the best prices.
  • Block-grant Medicaid to the states.
  • Removing barriers to allow drug providers that offer less expensive products to do so by decriminalizing importation of drugs from overseas sources.

No candidate is an island

Of course, neither candidate will be able to accomplish any reform on their own.  The U.S. Congress has a say in what will happen to the ACA.  To get a sense of how each party views this issue, let’s take a dive into the party platforms.

The Republican platform

The GOP platform is in fierce opposition to the ACA.  Their platform states that the ACA “weighs like the dead hand of the past upon American medicine.”

In its place, the GOP platform proposes:

  • A reduction of mandates to enable insurers and providers of care to increase healthcare options and contain costs.
  • A return to the states’ role of regulating local markets, limiting federal requirements on both private insurance and Medicaid, and calling on state officials to help the needy with access via block grants.
  • Similar to Trump’s site, the platform refers to transparency in pricing among health care providers but expands on the idea by requiring an agreement to price prior to care. 
  • A call to repeal of the 1945 McCarran-Ferguson Act, which protects insurance companies from anti-trust litigation and allows purchase of insurance across state lines.
  • Protection for providers who choose not to provide care that conflicts with their faith.

The Democrat platform

The Democrats are advocating the strengthening of the ACA with a continued push toward universal health care. 

To that end, their platform proposes:

  • Transparency in pricing.
  • A reduction in out-of-pocket costs.
  • A fight to phase out Medicare and opposition to block-grant Medicaid.
  • Support for health care for all, regardless of rural location.
  • A reduction of prescription drug costs through a crackdown on what is referred to as “price gouging” by the party platform.
  • Proposals to improve care for people with addiction and mental health issues.

The crystal ball remains fuzzy

Trying to predict the future of ACA is like trying to predict the election itself.  We have a sense of where it’s going but we won’t know until we get there.  The best we can do is make sure that we stay up-to-date with changes in regulations and prepare for all outcomes. TriNet is a great partner in helping to keep your company compliant through all the iterations of ACA to come.

This communication is for informational purposes only; it is not legal, tax or accounting advice; and is not an offer to sell, buy or procure insurance.

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