Compare 7 Key Healthcare Positions – Trump vs. Clinton

October 3, 2016 Phil C. Solomon

KEEP IT OR DITCH IT – That is the question – You be the judge

Side-by-Side Comparison of the Candidates’ Health Care Positions provided by Kaiser Family Foundation –

Hillary Clinton Donald Trump
Position on the ACA
  • Maintain and build upon the ACA.
  • Repeal the ACA in its entirety. Repealing the law would rollback many changes to private health insurance, coverage through Medicaid and the marketplaces, preventive and women’s health services, and Medicare coverage and savings provisions.
Health Insurance Coverage and Costs
Insurance Premiums
  • Increase premium tax credits available through the Marketplaces so that individuals and families pay no more than 8.5% of their income on health insurance premiums.
  • Work with interested governors to establish a public option plan in their states using current flexibility under the ACA.
  • Create a fallback process that gives the Secretary of Health and Human Services the authority to modify or block unreasonable health insurance rate increases in states that do not have such authority.
  • Fix the “family glitch”.
  • Repeal the Cadillac tax.
  • Allow people to buy health insurance across state lines.
  • Allow payments individuals make toward health care premiums to be tax deductible.
Out-of-Pocket Costs
  • Require plans to provide three sick visits per year that do not count towards deductibles.
  • Provide a new progressive refundable tax credit of up to $2,500 for an individual, $5,000 per family, for out-of-pocket costs (including marketplace premiums) in excess of 5% of income for insured individuals who are not eligible for Medicare or claiming existing deductions for medical costs.
  • Ensure consumers are required to pay no more than in-network cost-sharing for care received in a hospital in their plan’s network.
  • Enforce ACA transparency requirements; and require employers, providers, and insurers to provide more information about out-of-pocket costs, doctor networks, prescription drug costs, and other elements of health insurance so that consumers can make informed choices.
  • Allow people to enroll in tax-free Health Savings Accounts to pay for out-of-pocket costs, usable by all family members and inheritable without tax penalty.
  • Require price transparency from all health care providers to enable individuals to shop for the best prices on medical procedures.
Coverage for Immigrants
  • Allow families—regardless of immigration status—to buy insurance through the Health Insurance Marketplaces.
Outreach and Enrollment
  • Invest $500 million per year in a campaign to facilitate enrollment of eligible individuals into Marketplace coverage and Medicaid.
Medicaid Expansion
  • Encourage states to adopt the Medicaid expansion by allowing any state that expands Medicaid to receive a 100% federal match for the adult expansion population during the first three years, regardless of when the state chooses to expand.
Medicaid Financing
  • Maintain current Medicaid financing structure.
  • Transform Medicaid into a block-grant to states.
Medicare Buy-in
  • Allow people age 55-64 to buy-in to Medicare.
Medicare Drug Prices
  • Allow Medicare to negotiate drug prices, especially for high-cost drugs with limited competition.
  • Require drug manufacturers to provide rebates in the Medicare low-income subsidy program that are equivalent to rebates in the Medicaid program.
Payment System Reform
  • Expand value-based delivery system reform in Medicare and Medicaid, and propose public-private efforts that incentivize employers and insurers to expand these payment models.
  • Focus on prevention by helping school districts implement age-specific drug abuse education programs and help communities develop peer and mentorship programs.
  • Increase funding for the Substance Abuse Prevention and Treatment Block Grant by 15% to expand access to inpatient and outpatient treatment.
  • Create a state fund to help police, fire departments, and EMTs purchase naloxone, and ensure all first responders have access to it
  • Require licensed prescribers to meet training requirements and consult a prescription drug monitoring program before writing a prescription for controlled medications.
  • Direct the Department of Veterans Affairs and CMS to disseminate guidelines that identify treatments for pain management other than opioids.
Insurance Coverage
  • Ensure enforcement of insurance parity laws between physical and behavioral health.
  • Reevaluate Medicare and Medicaid payment practices to remove obstacles to reimbursement and help integrate care for addiction into standard practice.
Criminal Justice
  • Direct the Attorney General to issue guidance on prioritizing treatment over incarceration for nonviolent and low-level federal drug offenders.
Prescription Drugs
  • Allow Americans to import drugs for personal use from foreign nations whose safety standards are as strong as those in the US.
  • Allow consumers access to imported, safe and dependable drugs from overseas.
Out-of-Pocket Drug Costs
  • Require health insurance plans to place a monthly limit of $250 on covered out-of-pocket prescription drug costs for individuals.
Generic Drugs and Biologics
  • Increase the availability of generic drugs by prohibiting “pay-for-delay” deals and by fully funding the FDA’s Office of Generic Drugs to clear out their generic drug approval backlog.
  • Lower the biologic exclusivity period from 12 to 7 years and direct FDA to give prioritized, expedited review to biosimilar applications with only one or two competitors in the marketplace.
Drug Prices
  • Eliminate corporate tax deductions for direct-to-consumer advertising; and require FDA approval of these advertisements.
  • Require pharmaceutical companies that benefit from federal support to invest a “sufficient amount” of revenue in research and development or pay rebates to support basic research.
  • Build on ACA provisions that use the results of private-sector analyses to hold drug companies accountable for justifying costs.
Women’s Reproductive Health
Reproductive Health
  • Protect a woman’s right to make personal health decisions and preserve access to affordable contraception, preventive care, and safe, legal abortions.
  • Oppose efforts to defund Planned Parenthood.
  • Repeal the Hyde Amendment.
  • Opposes abortion except to save the life of the woman or in the cases of rape or incest.
  • Supports laws that would limit access to later term abortions.
  • Defund Planned Parenthood.
  • Make Hyde Amendment permanent law.
  • Provide emergency funding for Zika.
  • Create a Public Health Rapid Response Fund to invest in public health preparedness and address emerging disease threats like Zika.


 _______________Phil C. Solomon is the publisher of Revenue Cycle News, a healthcare business information blog and serves as the Vice President of Global Services for MiraMed, a healthcare revenue cycle outsourcing company.  As an executive leader, he is responsible for creating and executing sales and marketing strategies which drive new business development and client engagement. Phil has over 25 years’ experience consulting on a broad range of healthcare initiatives for clinical and revenue cycle performance improvement.  He has worked with industry’s largest health systems developing executable strategies for revenue enhancement, expense reduction, and clinical transformation. He can be reached at

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