Dive Brief:
- A new report released by the Commonwealth Fund, with analyses prepared by the RAND Corporation, compares the likely 2018 impacts of the Democratic and Republican presidential nominees' differing proposals on what to do with the ACA.
- Among the key findings of the report were that a repeal of the ACA under Donald Trump would be expected to decrease the number of people with health coverage by 15.6 million to 25.1 million.
- In comparison, under Hillary Clinton’s proposals to maintain and modify the ACA, it is expected that the number of those covered would increase by an amount between 400,000 and 9.6 million.
Dive Insight:
The healthcare and health insurance industries are in for an extremely different ride depending on which candidate prevails in the upcoming presidential election. That decision will determine whether or not the ACA with all its myriad policies will continue to exist, and how everything beyond the ACA is handled, from Medicaid reform, to affordability issues for premiums, prescriptions and other out-of-pocket costs.
Even if Clinton wins, change is to be expected. Perhaps one of the most-watched issues will be Clinton's push for a public option--a government-administered health plan that would compete with private plans in the marketplaces, which some suggest would pose a grave threat to its private competitors.
The new report provides a side-by-side comparison of the candidates' health proposals, based on what information their campaigns have provided publicly and provided to researchers upon request, along with "reasonable assumptions" based on the provided information.
In a nutshell, Trump's policies are projected not just to end the ACA and result in fewer insured Americans, but to increase insurance costs for the those on the individual market, and potentially cause low- and moderate- income people to pay more for coverage than higher income people. The policies are also projected to increase the federal deficit by $33.1 billion because any savings gained by eliminating subsidies and Medicaid expansion would be more than gobbled up by the loss of savings from the ACA's Medicare reforms, fees, and taxes.
Meanwhile, the RAND analyses concluded Clinton's policies would reduce out-of-pocket healthcare costs and have no impact on the deficit--if her proposals that would increase costs would in fact be covered, as she proposes, by rebates from drug manufacturers and taxes on higher-income families.