Trump vs. Clinton on Health Care: Their Differences Are Clear

Tony Lee By Tony Lee July 19, 2016
Trump vs. Clinton on Health Care: Their Differences Are Clear


The Society for Human Resource Management (SHRM) attended the Republican National Convention in Cleveland, reporting on events relevant to the HR profession. SHRM was the only HR organization at the convention and had a contingent, led by Henry G. "Hank" Jackson, SHRM president and CEO, representing SHRM members and the HR profession. SHRM attended the Democratic National Convention in Philadelphia the following week.

  • For SHRM's complete coverage of the 2016 Republican National Convention, click​ here.​​​​​​​
  • For SHRM's complete coverage of the 2016 Democratic National Convention, click​ here.​​​​​​​

Of all the issues debated by the Trump and Clinton campaigns, few offer a clearer picture of the candidates' philosophical differences than health care coverage. While Hillary Clinton says her goal is to preserve and build on the Affordable Care Act (ACA), Donald Trump has made clear his intention is to repeal current legislation and replace it with a system that requires less federal government support.

For HR professionals, understanding the differences between the candidates' positions should help to inform and influence their choice in November, based on their own health care priorities and those of their organizations.

"By monitoring the presidential candidates' positions on employer-sponsored health benefits, HR can better understand how they stand on such issues as the tax treatment of health benefits, the impending excise tax on high-value plans, wellness programs and the definition of full-time [employee]," said Chatrane Birbal, a government relations senior advisor at the Society for Human Resource Management (SHRM).

Health care policies also have a rising impact on talent acquisition strategies, as job candidates say the quality of employer-provided medical coverage is a top consideration when evaluating job offers, reports CareerBuilder, which adds that this concern ranks especially high among Millennials.

"Employer-sponsored health benefits are critical to recruiting and retaining a talented workforce, so any health care reform legislation must support employer flexibility and innovative strategies and preserve the favorable tax treatment of employer-sponsored coverage," said Mike Aitken, SHRM's vice president of government affairs.

To evaluate Trump's health care plans, look no further than his campaign website, which outlines the following key components of his health care reform proposal:

  • Repeal and replace the Affordable Care Act.
  • Institute a cap on employer-tax exclusion for health care.
  • Seek medical malpractice reform.
  • Expand employer-sponsored wellness programs.
Other aspects of health care reform that Trump has proposed so far include lowering trade barriers to allow overseas drug makers to sell in the U.S., requiring greater transparency from doctors and hospitals on pricing, and allowing health insurance to be sold across state lines. Trump also proposes state block grants for Medicaid while promising to improve Medicare by "making the country rich."

Across the aisle, Clinton and her legislative supporters seek to defend and expand the ACA. They also propose to control prescription drug prices by holding drug companies more accountable, and she says she would expand pricing disclosure requirements for doctors and hospitals, according to her campaign website. Clinton also is a supporter of new incentives to encourage states to expand Medicaid, and she supports allowing U.S. individuals ages 50 and older to purchase Medicare coverage. She is in favor of elevating mental health treatment to be on par with physical health coverage. On the issue of selling health insurance across state lines, Clinton has said she has an open mind, but that this topic isn't currently part of the Democratic party platform.​​

To see a full comparison of how both candidates stand on health care issues, please review the following charts provided by each campaign:​​​​

 ​Donald Trump's Health Care Reform Plan:

  • Repeal ACA
  • Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
  • Tax deductible health insurance premium payments. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system.
  • Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
  • Price transparency. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
  • Reform mental health programs. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.
  • Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
  • Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

Hillary C​li​​nton's Health Care Reform Plan:

  • Defend the Affordable Care Act. Clinton will co​ntinue to defend the ACA against Republican efforts to repeal it.
  • Lower out-of-pocket costs like copays and deductibles. The average deductible for employer-sponsored health plans rose from $1,240 in 2002 to about $2,500 in 2013. Clinton believes that workers should share in slower growth of national health care spending through lower costs.
  • Reduce the cost of prescription drugs. Prescription drug spending accelerated from 2.5 percent in 2013 to 12.6 percent in 2014. It’s no wonder that almost three-quarters of Americans believe prescription drug costs are unreasonable. Clinton believes we need to demand lower drug costs for hardworking families and seniors.
  • Build on the Affordable Care Act and require plans to provide three sick visits without counting toward deductibles every year. The Affordable Care Act required nearly all plans to offer many preventive services, such as blood pressure screening and vaccines, with no cost-sharing at all. But because average deductibles have more than doubled over the past decade, many Americans would have to pay a significant cost out-of-pocket toward their deductible if they get sick and need to see a doctor. Clinton’s plan will build on the Affordable Care Act by requiring insurers and employers to provide up to three sick visits to a doctor per year without needing to meet the plan’s deductible first.
  • Provide a new, progressive refundable tax credit of up to $5,000 per family for excessive out-of-pocket costs. For families that still struggle with prescription drug costs even after out-of-pocket limits on drug spending and free primary care visits, Clinton’s plan will provide progressive, targeted new relief. Americans with health coverage will be eligible for a new refundable tax credit of up to $2,500 for an individual, or $5,000 for a family, available to those with substantial out-of-pocket health care costs. The credit will be available to insured ​Americans with qualifying out-of-pocket health expenses in excess of five percent of their income, and who are not eligible for Medicare or claiming existing deductions for medical costs. This refundable, progressive credit will help middle-class Americans who may not benefit as much from currently-available deductions for medical expenses. This tax cut will be fully paid for by demanding rebates from drug manufacturers and asking the most fortunate to pay their fair share.
  • Enforce and Broaden the ACA’s Transparency Provisions. Americans deserve real-time, updated, and reliable information to guide them in selecting a health plan, navigating changes to their out-of-pocket costs in their existing plan, choosing a doctor, and determining how much they will need to pay for a prescription drug. Clinton’s plan will vigorously enforce existing law under the Affordable Care Act and adopt further steps to make sure that employers, providers, and insurers provide this information through clear and accessible forms of communication so that Americans can make informed choices about their coverage and realize meaningful savings.
  • Repeal the ACA “Cadillac Tax” 



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