Trump, Clinton's healthcare plans would achieve opposite results, studies find

Voters know Donald Trump and Hillary Clinton's healthcare plans are dramatically different, but they may not realize just how distinct they are: A pair of studies conducted by Rand Corp., and released by The Commonwealth Fund suggests the candidates' plans would achieve almost opposite outcomes.

The reports use a computer microsimulation model to extrapolate the effects of each candidate's healthcare plan on insurance coverage, deficit and consumer cost burden. The researchers did not map every policy the candidates have put forth, only those with enough detail to model.

"These analyses give people the best possible estimates for how healthcare would be affected by each candidate, given the information made available. It's clear that there are two widely disparate approaches to ensuring Americans' healthcare coverage, access to the care they need, and protection from burdensome healthcare costs," Commonwealth Fund President David Blumenthal, MD, said in a statement.

Here is an overview of what each candidate has proposed and a breakdown of how their policies would affect U.S. healthcare.

1. Ms. Clinton's proposals
Ms. Clinton advocates for maintaining the Affordable Care Act, while making several key modifications to the law. Some of her proposed amendments include providing refundable tax credits to privately insured Americans whose premium and out-of-pocket costs exceed 5 percent of income; lowering the maximum premium contribution on the marketplace to 8.5 percent of income; providing premium tax credits to families covered under employer plans whose plans exceed 8.5 percent of income; and adding a public option to the ACA marketplaces. Ms. Clinton's plans to continue to expand Medicaid and lower the Medicare age were not included in the analysis.

2. Mr. Trump's proposals
On the flip side, Mr. Trump would repeal and replace the ACA if elected in November. In place of the healthcare reform law, he would make premiums on the individual market fully tax deductible; covert Medicaid and CHIP to block grants; and allow interstate insurance sales.

3. Insurance coverage
The analysis of Ms. Clinton's plans indicates an additional 9 million people would gain health insurance coverage in 2018, while the analysis of Mr. Trump's plan indicates 20.2 million Americans would lose health insurance coverage in 2018.  

4. Federal deficit
Both of the candidate's plans analyzed, when subtotaled, would increase federal deficit by more than $100 billion. Ms. Clinton's tax credit proposal would increase deficit by $90.4 billion, while reducing the maximum premium contribution to 8.5 percent would increase deficit by an additional $3.5 billion. Fixing the "family glitch" for maximum premium contributions for families on employer plans would add $10 billion to the deficit. Only her proposal to add a public option would lower the deficit, by $700 million.

Mr. Trump's plans would increase deficit across the board. Repealing the ACA would add $33.1 billion to the deficit, replacing it with tax-deductible premiums would increase deficit by $41 billion, Medicaid block grants would add $500 million and interstate insurance sales would add $33.7 billion.

5. Out-of-pocket spending
Ms. Clinton's tax credits would help low- and moderate-income Americans, who earn between 139 and 250 percent of the federal poverty level, spend 33 percent less out-of-pocket on healthcare costs, according to the analysis. Mr. Trump's plan would increase out-of-pocket costs for ACA enrollees anywhere from $300 a year to $2,500 a year.

Read the full analysis of Ms. Clinton's healthcare proposal here and the analysis of Mr. Trump's here.

 

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