Although it is difficult to accurately assess the financial impact of either presidential candidate's platforms at this point in the race, the nonpartisan, nonprofit financial watchdog group, the Committee for a Responsible Federal Budget(CRFB), has analyzed each candidate's health care plan with some surprising conclusions. Despite a $14 trillion debt that will increasingly consume much of the country's GDP, it appears that both Republican nominee Donald Trump and Democratic nominee Hillary Clinton are committed to health care reforms that will add hundreds of billions of dollars to that staggering debt.
An initial analysis suggests that Clinton's health care changes would cost almost $150 billion over ten years, if economic returns are factored into the estimate. However, the CRFB estimates Clinton's proposals could possibly cost about $300 billion if certain mitigating factors fail to materialize. In contrast, Trump's proposed changes are likely to cost $50 billion over ten years, but could possibly reach as high as $550 billion.
Both candidates are committed to making significant changes to the Affordable Care Act. Ms. Clinton would keep the law and include changes like expand Medicaid to more states, cap out-of-pocket costs, increase subsidies and implement new tax credits. Mr. Trump is in favor of repealing ACA, which would diminish spending on insurance and spur economic growth. CRFB estimates that Clinton's changes would cost the nation almost $300 billion, while Trump's plan would cost $500 billion initially but would recoup almost $300 billion through economic stimulus.
Both candidates would like to make changes to health care related taxes. Clinton would like to eliminate the "Cadillac Tax," a tax on high cost employer health plans. The CRFB estimates this will likely cost almost $100 billion over ten years. There is a similar cost attached to Trump's plan to allow tax deductible health savings accounts.
Clinton and Trump have provisions in their platforms that would also generate revenue for the country. Both nominees would like to lower the cost of drug production. Clinton proposes a minimum rebate for pharmaceutical manufacturers to participate in Medicare as well as allowing states the option for a public health insurance, which would help control insurance costs. The CRFB estimates these proposals could generate almost $200 billion over ten years.
In his proposal, Donald Trump would like for Medicare to negotiate drug prices directly with manufacturers. He would also grant consumers the right to purchase health insurance across state lines. His plan could generate almost $50 billion in revenue over ten years, according to the CRFB.
It is difficult to accurately determine the ramifications of either candidates' health care policies. While Clinton is likely to work within the ACA framework, she has proposed major changes like the "public option" which could allow Americans younger than 65 to enroll in Medicare. Trump, on the other hand, will have to generate an entirely new health insurance system if he intends to follow through on his promise to repeal Obamacare. In either case, there are likely to be major, and costly, changes in American health care during the next President's time in office.
Article written by:
Robert Moghim, M.D.
CEO, Health Carousel Locum Tenens