While ideological divides on U.S. health care policy remain wide, the next Congress and administration will face several key issues that, regardless of the November election outcomes, will require bipartisan collaboration to address. In addition, there will be several potential opportunities for bipartisan agreement to further advance the health of the American public. Here we examine the current political divides and opportunities for action in the coming years.
— Health Affairs (@Health_Affairs) October 11, 2016
Existing Partisan Fault Lines
Congressional Democrats, the Obama Administration, and the 2016 Democratic National Committee platform are unified in their support for preserving and building on the Affordable Care Act (ACA). President Obama and other supporters of the ACA tout the law’s progress in reducing the uninsured rate, improving quality of care, and reducing per-enrollee health care spending across private payers, Medicaid, and Medicare. To further reduce the uninsured rate, Democratic presidential candidate Hillary Clinton proposes expanding Medicaid for low-income Americans in the 19 states that have not done so under the ACA, allowing individuals aged 55-64 to buy into Medicare, and creating a new public insurance option to be sold alongside private plans in the Health Insurance Marketplace.
The GOP Health Care Reform Task Force and the 2016 Republican National Committee (RNC) platform seek to repeal and replace the ACA in ways that would restore and expand authority to states and provide more options for consumers, for example by promoting Health Savings Accounts and Health Reimbursement Accounts for the purchase of insurance, allowing insurance sales across state lines, and converting Medicaid to a block grant or per-capita allotment to enhance state flexibility in program administration. Other proposals would promote private-sector, free-market solutions including Medicare “premium support” with an exchange for Medicare plans to compete with one another. GOP presidential candidate Donald Trump has vowed to repeal and replace the ACA, a principle also included in the Health Care Reform Task Force and the RNC Platform. However, the Senate is not likely to have the 60 votes needed to pass a wholesale repeal.
KEYWORDS: MEDICARE, PRESIDENT BARACK OBAMA, AFFORDABLE CARE ACT, MEDICAID, 2016, HILLARY CLINTON, BILL HOAGLAND, JANET MARCHIBRODA, KATHERINE HAYES, LISEL LOY, BPC OP-EDS, DONALD TRUMP, ANAND PAREKH, 115TH CONGRESS