Now that Hillary Clinton is the Democratic Presidential nominee, it’s time to delve into her health policy platform. The quick recap is she is looking to expand and build on ACA, tweaking various parts and pieces to fix legislative errors, incent states to participate, and reduce out of pocket costs. (we discussed this in yesterday’s Blab; you can watch it here.)
Clinton would offer 100% funding for any state that expands Medicaid for at least three years, then tapering down to 90%. This would likely encourage more states to take the step; Florida and Nebraska are two where elected officials are under increasing pressure to make the move.
Remove the family glitch
A drafting error doesn’t allow taking an employee’s family into account when determining subsidies for insurance bought via the Exchanges. Clinton would offer tax credits to offset those out of pocket costs for eligible families. The tax credit proposal is a convoluted way to fix what should be done via correcting the original language.
Allow near-seniors to buy-in to Medicare
More an idea than an actual policy position, Clinton is talking about allowing “people 55 or 50 and up” to voluntarily pay the entire “premium” to join Medicare. With much to be fleshed out, this looks to be a response to Sen Sanders’ call for free public insurance for all.
This could have some major downstream effects; by removing we older and more expensive people from the privately-insured pool, insurance costs for younger folks would decrease. This “public” option would also inject competition into areas where there isn’t any due; rural markets in particular could benefit.
Address drug prices
Clinton has several ideas including eliminating the tax deductibility of marketing expenses, setting limits on consumers’ out of pocket costs for prescription drugs, and allowing Medicare to negotiate directly with drug companies.
Most striking is the mostly-unformed concept of forcing drug developers to spend a set amount on R&D, with any additional revenues handed back to the Feds for government research on new therapies. This is intended to address the industry’s argument that research costs demand high prices (an oft-criticized and rather doubtful argument).
Sounds good, but I doubt – very much – if it could be implemented without causing a lot of problems as drug companies quickly figure out ways to game the system.
At some point it may make sense to review Trump’s, but at this point the GOP nominee has yet to come forth with any coherent health reform plan other than “repeal Obamacare” and sell insurance across state lines.