Comparing the 2016 Presidential Candidates’ Health Proposals

Add government-administered public insurance plan to compete with private plans in the marketplaces.

2018 IMPACT

Invest $500 million annually in an enrollment campaign.

Allow people to purchase marketplace plans regardless of immigration status.

100% federal match for enrollees who qualify under the Medicaid expansion (covering adults up to 138% of the poverty level) for the first three years, regardless of start date. While Medicaid is jointly funded by federal and state governments, under current law the federal government pays 100% of health care costs for enrollees who qualify under the expansion through 2016. After that, the federal match tapers down to 90% by 2020.

Repeal “Cadillac tax” on high-cost employer health plans.

Expand eligibility for small-business tax credit to firms with up to 50 workers, up from a limit of 25 workers.

Allow people ages 55 and older to buy into Medicare, which is currently open only to people ages 65 and older and people with disabilities.

Enhance premium tax credits, so that enrollees pay no more than 8.5% of their income toward premiums, down from 9.66%.

2018 IMPACT

Fix the so-called “family glitch” for marketplace tax credits whereby families with access to employer coverage are eligible for tax credits only if the worker’s premium contribution for single enrollee’s coverage exceeds the affordability threshold, which would be set at 8.5% of income consistent with the proposed change to premium tax credits. Because family contributions often exceed single contributions, many families are left with unaffordable coverage. The impact is the combined effect of the fix and the enhanced premium tax credits.

2018 IMPACT

Strengthen ability of states to modify or block premium rate hikes.

Vigorously enforce antitrust laws in health care markets.

Provide a refundable tax credit to help insured Americans pay for qualifying out-of-pocket costs that exceed 5% of income. The credit, up to $2,500 for an individual and $5,000 for a family, would be available to people who are not eligible for Medicare and do not claim existing deductions for medical costs.

2018 IMPACT

Require that insurers and employers exclude up to three sick visits per year from the plan deductible.

Provide protections from surprise medical bills by ensuring that consumers cannot be charged more than in-network cost-sharing for care received in a hospital, and for a medical emergency.

Ensure that consumers have up-to-date information to help them select health plans, understand out-of-pocket costs, choose doctors, and make other informed decisions about their coverage and health care.

Require that health plans cap out-of-pocket spending on covered prescription drugs at $250 a month.

End corporate tax write-offs for direct-to-consumer drug advertising.

Require drug companies that receive federal support to invest a sufficient amount of their revenue in R&D.

Allow imported drugs for personal use if they meet federal quality and safety standards.

Clear Food and Drug Administration generic backlog and reduce biologic exclusivity periods.

Prohibit “pay-for-delay” arrangements that allow drug manufacturers to keep generic competition off the market.

Raise Medicare rebates for low-income enrollees to the more generous levels currently offered in Medicaid.

Let Medicare negotiate drug prices.

Ensure drug prices reflect the value of drugs.

Strengthen enforcement of 2008 mental health parity law that requires insurers to cover mental illness the same way they cover physical illness by using insurer audits and compliance monitoring, and by making it easier for consumers to report violations.

Improve integration and coordination of mental and physical health care systems through collaborative payment approaches.

Launch $7.5 billion fund to support new federal-state partnerships over 10 years to prevent and treat addiction.

Increase the Substance Abuse Prevention and Treatment Block Grant by $2.5 billion over 10 years to expand in- and out-patient substance abuse care.

Allow nurse practitioners and physician assistants to prescribe medications for opioid addiction.

Tax credits of up to $6,000 to offset family caregiving costs.

Apply a credit toward caregivers’ Social Security benefits for the time they are out of the paid workforce taking care of a family member.

Invest $100 million over 10 years in Caregiver Respite program, which provides respite for family caregivers of children and adults.

Cover comprehensive Alzheimer’s care-planning services and help coordinate care among physicians.

Reauthorize the Missing Alzheimer’s Disease Patient Alert Program for patients who wander.

Double funding over 10 years for primary care services at community health centers and triple size of National Health Service Corps to increase the primary care workforce in underserved areas.

Build on reforms to reward value and quality, such as bundled payments and accountable care organizations.

Expand value-based delivery system reform in Medicare and Medicaid and support efforts that incentivize employers and private insurers to adopt these payment models.

Broaden scope of providers and services eligible for telehealth payments.

Make price and quality information more transparent.

Eliminate fraud and abuse.