As Donald Trump and Hillary Clinton square off tonight in the first of three debates, here are where each of them stands on health care. These are taken directly from their campaign websites, and are published verbatim.
As president, Hillary [Clinton] will:
- Defend and expand the Affordable Care Act, which covers 20 million people. Hillary will stand up to Republican-led attacks on this landmark law—and build on its success to bring the promise of affordable health care to more people and make a “public option” possible. She will also support letting people over 55 years old buy into Medicare.
- Bring down out-of-pocket costs like copays and deductibles. American families are being squeezed by rising out-of-pocket health care costs. Hillary 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. Hillary believes we need to demand lower drug costs for hardworking families and seniors. Read more here.
- Protect consumers from unjustified prescription drug price increases from companies that market long-standing, life-saving treatments and face little or no competition. Hillary’s plan includes new enforcement tools that make drug alternatives available and increase competition, broaden emergency access to high-quality treatments from developed countries with strong safety standards, and hold drug companies accountable for unjustified price increases with new penalties. Read more here.
- Fight for health insurance for the lowest-income Americans in every state by incentivizing states to expand Medicaid—and make enrollment through Medicaid and the Affordable Care Act easier.
- Expand access to affordable health care to families regardless of immigration status. Hillary will expand access to affordable health care to families regardless of immigration status by allowing families to buy health insurance on the health exchanges regardless of their immigration status.
- Expand access to rural Americans, who often have difficulty finding quality, affordable health care. Hillary will explore cost-effective ways to make more health care providers eligible for telehealth reimbursement under Medicare and other programs, including federally qualified health centers and rural health clinics.
- Defend access to reproductive health care. Hillary will work to ensure that all women have access to preventive care, affordable contraception, and safe and legal abortion.
- Double funding for community health centers, and support the healthcare workforce: As part of her comprehensive health care agenda, Hillary is committed to doubling the funding for primary-care services at community health centers over the next decade. Hillary also supports President Obama’s call for a near tripling of the size of the National Health Service Corps.
More than 40 million adults in America—nearly 1 in 5—and 17 million children are coping with a mental health problem. Too many individuals are being left to deal with these issues on their own, and many face complicating life circumstances like drug and alcohol addiction, homelessness, incarceration, or chronic health conditions.
These Americans and their families need our support. Hillary Clinton strongly believes we have to bring mental and behavioral health care on par with physical health care—and end the shame and stigma associated with treatment. To that end, she has announced a comprehensive mental health agenda that will:
- Promote early diagnosis and intervention. The majority of Americans living with lifelong mental health illnesses show signs of distress at an early age, and yet few are treated. As president, Hillary will increase public awareness and action to address maternal depression, infant mental health, and trauma and stress in the lives of young children. She will scale up funding for programs through which pediatricians and schools seek to identify and support children facing behavioral problems. And she will encourage colleges and universities to provide comprehensive mental health services.
- Launch a national initiative for suicide prevention. America is facing the highest suicide rate in 30 years—and it’s becoming increasingly prevalent among adolescents, college students, veterans, and older adults. As president, Hillary will create a national, cross-governmental suicide prevention initiative to be led by the surgeon general and involve all relevant agencies, from HHS to the VA to USDA. She’ll provide federal support for suicide prevention programs in high schools and on college campuses, and she’ll work to ensure schools are meeting the mental health needs of all students—particularly LGBT students and students of color.
- Integrate our nation’s mental and physical health care systems so that health care delivery focuses on the “whole person” and expand community-based treatment. Hillary will work to foster better integration of our health care systems so that high-quality behavioral care—for mental health problems and as well as addiction—is available in general health care settings. She’ll launch a national strategy to increase the number of mental health providers. And she will support the creation of top grade, comprehensive community health centers in every state where behavioral care is available.
- Prioritize treatment over jail for low-level, nonviolent offenders and help train law enforcement officers in responding to conflicts involving persons with mental illness. Hillary will increase investments in local programs, such as specialized courts, drug courts, and veterans’ treatment courts, which emphasize treatment and rehabilitation over incarceration. She will also direct the attorney general to issue guidance to federal prosecutors, instructing them to prioritize treatment over incarceration for low-level, nonviolent offenders. And she will ensure adequate training for law enforcement on crisis intervention so that officers can properly and safely respond to individuals with mental illness.
- Enforce mental health parity to the full extent of the law. The Mental Health Parity and Addiction Equity Act of 2008, which Hillary proudly co-sponsored, requires group health plans to provide the same level of benefits for mental health as other medical conditions. Despite the law, too many Americans seeking mental health treatment still get turned away. Hillary will strengthen federal monitoring to make sure insurers are complying with the mental health parity law—and she’ll make it easier for patients to file a complaint when their rights are violated.
- Improve access to housing and job opportunities. Hillary will launch a joint initiative among HUD, HHS, and USDA to expand community-based housing opportunities for individuals with mental illness and other disabilities. She’ll work with private employers and state and local mental health authorities to expand job opportunities for Americans with mental health issues. And she’ll increase support for the Protection and Advocacy for Individuals with Mental Illness (PAIMI) program.
- Invest in brain behavioral science research. As part of a broad new investment in scientific research, Hillary will provide new federal funding for research into brain development and human behavior, promote research partnerships across sectors, and ensure data is widely shared.
HEALTHCARE REFORM TO MAKE AMERICA GREAT AGAIN
Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.
But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.
However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.
Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.
Congress must act. Our elected representatives in the House and Senate must:
- Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
- 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.
- Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
- 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.
- 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.
- 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. Congress will need the courage to step away from the special interests and do what is right for America. 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.
The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation.
Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.
To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.
Finally, we need to reform our mental health programs and institutions in this country. 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.
To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country. These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again.