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Where do the 2024 Presidential Candidates Stand on Healthcare Issues?

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Trump vs. Biden Impact on Healthcare & Health Insurance

When the choices are two elderly men vying for the most powerful position in the World, pit against each other in a nasty battle of vastly different personalities, it is important to refocus on the issues that impact you. This article highlights the key differences between a Trump presidency and Biden’s as it relates to healthcare and insurance. For specific details on how these changes may impact your organization, be sure to work with your Leavitt Group Trusted Advisor.

A Trump Presidency

The Trump presidency caused much disruption in the healthcare and insurance space due to Executive Orders demanding the Departments of Health and Human Services (HHS) and Treasury (IRS) implement regulations laid out in those orders. See the prior Leavitt Group articles –

Trump Hurdles

One hurdle former President Trump must clear include his many legal problems. For the first time in U.S. history, a presidential candidate is also a convicted felon and someone who has been previously convicted in civil court for abusing a woman. While the latest court challenge related to his actions on January 6th was appealed to the Supreme Court of the United States (SCOTUS), awaiting a decision any day now, former President Trump still awaits additional criminal cases to come. See the transcript of the presidential immunity defense for the January 6th case – U.S. Supreme Court Case Trump vs. United States.

Trump Policies

The former President Trump’s record on healthcare illustrates his priorities although he limits conventional policy proposals. During the Trump Administration, the former President took action to:


Trump’s Plan for a Second Term

Trump’s unpredictability on solid policy makes it difficult to outline his plans for a second term. Rarely giving details, his record may provide the only clear answer as to his position on healthcare for a potential next term. (See below “Reversing Trump Administration Executive Orders” for more details on Trump policies overturned during the Biden Administration). These include previous positions Former President Trump would likely build upon or reinstitute in a second term, including:

  • Eliminating surprise medical bills for emergency services (No Surprises Act),
  • Cuts to entitlement programs such as Medicaid, Medicare and Social Security,
  • Expansion of telehealth to include service across state lines and as first-dollar coverage (further extended and built upon during the Biden Administration),
  • Loosening of the Health Savings Account (HSA) rules to allow first-dollar coverage for maintenance drugs for certain chronic conditions, and
  • Healthcare price transparency.

See the Donald Trump limited language on healthcare policy here.

Former President Trump has also doubled down on his approach to reproductive health by stating he supports states with restrictive bans on abortion. Trump now indicates he would also back a national ban on abortion after 16 weeks with exceptions for rape, incest, and to protect the life of the mother. If Trump wins the election and the Republicans remain in control of Congress, he will be able to impose that limit on the 30 states that will allow abortion after 16 weeks.

 

A Biden Presidency

Just shy of four years since President Biden took office, Biden has illustrated his position on many key healthcare factors, following through on some important campaign promises. See the prior Leavitt Group article – What a Biden-Democratic Congressional Majority Means for Healthcare.

Senate Congressional Map for 2024 Election Year

House of Representatives Map for 2024 Election Year

 

Biden Hurdles

President Biden is not immune from arguments related to legal problems. His son was convicted of illegally obtaining a firearm, causing President Biden to address concerns with the Department of Justice impartiality. While Hunter Biden appeals his conviction, it is yet too soon to see whether the conclusion of the Biden case will impact the President.

Another hurdle for successful roll-out of the Biden healthcare plan is a split Congress. When Biden entered office, he was handed a Democratic-led Congress, making it easier to pass through his policies. This time, Biden must work with a Republican majority in Congress which has no doubt made it more difficult to push through the legislative process.

Biden Policies

Typical of new administrations, President Biden wasted no time in reversing Trump era Executive Orders upon entering office. Including the below.

Reversing Trump Administration Executive Orders

Any orders and regulations intended to undermine or water down the Affordable Care Act (ACA), a.k.a, ObamaCare, saw Biden executive orders reversing them. For example:

Reproductive Rights and Abortion

President Biden promotes women’s reproductive rights in his policies. When the Dobb’s decision overturning Roe v. Wade happened during the Biden Administration as a result of Trump appointed Justices, the Biden Administration worked to strengthen rules protecting privacy in reproductive health and participated in Court challenges seeking to limit those rights. Additionally, Biden indicated he would veto any bill during his administration that would include a national ban on abortion. See the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy. See the SCOTUS discussion on the case that ultimately decided States with abortion bans are barred from enforcing that ban in conflict with the Emergency Medical Treatment And Labor Act (EMTALA) – Supreme Court divided over federal-state conflict on emergency abortion ban – SCOTUSblog.

Insurance Coverage

While Trump promised to overturn the ACA (the ACA which incidentally lowered the uninsured rate from 17 percent to 9 percent), he failed to come up with the promised replacement plan during his administration. Instead, he made it harder for ACA plans to subsidize the insurance premiums for low-to-moderate-income families and individuals and cut advertising and funding for the ACA.

When President Biden assumed office, he and the Democratic-leaning Congress reversed most of the Trump era policies watering down the ACA.

Biden also enhanced funding for long-term care allowing access in Medicaid for home care services.

Prescription Drugs

The Trump Administration failed to enact widespread cost cutting measures for prescription drugs (other than for insulin for Medicare recipients), in some cases due to legal challenges to his attempts. President Biden was successful in enacting legislation that allows for a reduction in prescription drug prices following the Inflation Reduction Act of 2022. Biden’s plan gives Medicare the right to negotiate the price of its 10 most costly drugs beginning in 2026, with that number growing in subsequent years. This new rule has also faced legal challenges but thus far the Biden Administration has been successful in blocking injunctions.


Biden’s Current Plan for Healthcare

President Biden laid out his plans for healthcare in the 2025 Fiscal Budget Plan. While many policies are illustrated in the budget, we outline the key healthcare approaches below.

Expand Coverage and Lower Healthcare Costs

President Biden’s Fiscal Year 2025 Budget includes funding for extending Exchange Marketplace affordability, capping the cost of insulin prescriptions purchased through commercial insurance, as well as addressing affordability of other key prescription drugs.

  • The 2025 budget works to lower costs to ensure even more Americans have access to coverage by making permanent the enhanced premium tax credits extended through 2025 in the Inflation Reduction Act. The budget provides Medicaid-like coverage to low-income individuals living in states that have not expanded Medicaid under the Affordable Care Act, paired with financial incentives to ensure states maintain their existing expansions. The budget extends the consumer surprise billing protections in the No Surprises Act to ground ambulances.
  • The budget also promotes continuity of coverage and care for children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP), building on the existing 12-month continuous eligibility for children.
  • The budget extends Medicare solvency indefinitely, without cutting benefits.

Strengthen Maternal and Reproductive Health Outcomes. The Biden Administration has taken action to protect and expand access to reproductive health care, including abortion and contraception care. (See above).

Transform Behavioral Healthcare. The Biden Administration has committed the largest investment in behavioral health in a generation by increasing the number of counselors in schools.

  • The budget proposes $20.8 billion in behavioral health investments across the Department in FY 2025, an increase of $2.2 billion above FY 2023. Additionally, the budget proposes to invest over $70 billion in new federal mandatory funding over 10 years, including proposals that would enable more Americans with commercial insurance, Medicare, and Medicaid to access mental health and substance use disorder services.
  • The National Suicide Prevention Lifeline’s transition from a 10-digit number to 9-8-8 has been a success, and planned investments will help grow its impact. 9-8-8 is a 24/7 lifeline that provides people in crisis access to trained counselors. The Substance use And Mental Health Services Administration will dedicate $602 million to the 9-8-8 suicide and crisis lifeline, an increase of $100 million over FY 2023.
  • The budget expands coverage for behavioral health services, including improving behavioral health benefits for people with Medicare and Medicaid and in the commercial insurance market, with an emphasis on improving access, promoting equity, and fostering innovation.
  • The budget increases access to treatment for substance use disorders and helps respond to overdose deaths.

Conclusion

With the presidential election just over four months away, it is important to consider the policy and position of each candidate as we approach the election. While every presidential election is important, the 2024 election cycle may prove to be one of the most important for key issues facing the American public, such as reproductive rights, cost of healthcare and discrimination. Stay on top of the latest policies impacting those issues, be sure you are subscribed to the Leavitt Group news alerts.

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