Where Trump and Biden stand in health care

This article is part of The Wall Street Journal’s guide comparing President Trump and former Vice President Joe Biden on issues from climate change to health care and work.

Washington — Most of the healthcare differences between President Trump and Democratic presidential candidate Joe Biden are in line with the central controversy. Mr. Trump wants to reduce the role of the federal government in American health care, while Mr. Biden wants to expand it.

Both sides agree that medical costs should be reduced, but there is disagreement about how to deal with coronavirus pandemics, health insurance, prescription drug price cuts, and premium cuts.

Mr. Trump has filed many proceedings overriding the Affordable Care Act, which attempted to set thresholds for certain basic coverage nationwide while providing federal subsidies for people to pay for insurance. I supported it. The president moved his decision away from Washington and back into the state. He upheld Medicaid’s working requirements and helped the state pursue new arrangements for Medicaid payments. He also wants the state to import certain drugs from other countries, such as Canada, to promote competition and lower prices.

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Biden called on some people in the states who did not expand Medicaid to subsidize the federal government by automatically enrolling in a federal public option similar to Medicare. The former Vice President said he would try to overturn the changes in the Trump administration that undermined the ACA and suggested expanding the program by making public options available to people. Biden insisted that Medicare be able to negotiate drug prices.

Coronavirus response

Trump, who tested positive for Covid-19 this month, founded the White House Coronavirus Task Force in January to oversee the federal response to a pandemic, including contact tracing and acquisitions. I left a lot of concrete things. Specific supply to the state. Mr. Biden suggested that the federal government play a more focused and proactive role in responding to the crisis.

Mr Biden said he would encourage all Americans to wear masks and work with state leaders on mask obligations. Mr. Trump does not require a mask obligation.

Biden will also regain funding for the World Health Organization. The president has withdrawn the United States from the organization and is allocating money to other health programs.

Health insurance

Mr. Trump promised to abolish ACA and replace it with a better alternative, but neither could be done during his tenure. Mr. Trump has supported an important part of the Republican-led state coalition proceedings to invalidate the ACA. The case will be heard in the Supreme Court on November 10.

Mr. Trump signed two executive orders in September, proclaiming a U.S. policy to provide insurance protection to existing Americans, and working with Congress to surprise patients with the Department of Health and Human Services. Instructed to pass a law that protects against medical care. Bills. He doesn’t elaborate on how to specifically cover people in existing conditions. He also recently announced that 33 million Medicare beneficiaries will soon receive a card by mail that can be used to pay up to $ 200 for prescription drug costs.

Mr. Trump said his actions will reduce insurance costs, including increased access to short-term health insurance. This is a cheaper insurance product as it does not offer the same benefits as ACA compliant insurance.

The focus will be on coverage and costs as the United States has lost some of the profits it has made from lowering the rank of uninsured. According to the US Census Bureau, the number of uninsured Americans increased by about 2 million in 2018, the first increase in 10 years.

Biden proposed strengthening the ACA by expanding federal subsidies. He wants to expand Medicare’s eligibility requirements and supports public option plans that allow people to enroll in government-run insurance plans. His plan will give everyone, including those with employer-provided health insurance, the option to buy insurance like Medicare. That option would automatically cover low-income residents of the state who would not have expanded Medicaid, but would have been eligible for the program.

Biden supports reducing the eligible age for Medicare from 65 to 60. This will increase Medicare spending overall, estimated at billions of dollars annually. However, it also shifts some people from Medicaid to Medicare, reducing the number of people covered by employers, which can also reduce the cost of insurance premiums. The plan aims to reduce patient costs by leveraging the greater bargaining power of the program with hospitals and other healthcare organizations.

According to an analysis by Avalere Health, a Washington-based healthcare consulting group, younger Medicare could enroll more than 20 million people in the program. In contrast, Mr. Trump’s endorsed proceedings to invalidate the ACA could result in 20 million Americans losing coverage.

Drug price

Mr. Trump and Mr. Biden differ in how they achieve the common goal of lowering drug prices. Trump, who campaigned to reduce drug prices in 2016, has repeatedly urged pharmaceutical companies to offer Medicare drugs at lower prices by accelerating the process of approving new generic drugs that could reduce prices. Stated. The price they offer to other countries. He also signed an executive order to import drugs from low-priced countries and upheld the termination rebate that pharmaceutical companies offer to third parties that control the interests of pharmacies with the aim of lowering the list price of government drugs. Did. In the current system, pharmacy benefit managers negotiate secret rebates and discounts for many branded prescription drugs. These transactions are not always passed on to pharmacy customers.

Mr. Trump wants Medicare people to pay the same lower drug prices as in Europe, and he supports the out-of-pocket limits for people in the Medicare apartment D prescription range.

Biden is proposing to have Medicare negotiate a significant discount on the drug. He set up an independent review board to determine the value of the new drug by comparing the price of the new drug with that charged in other countries.

He will impose tax penalties on pharmaceutical companies that raise the price of certain drugs beyond general inflation.

Medical bills

Mr. Trump’s efforts to reduce costs exceed drug prices. He also aims to end the secret of negotiated prices between providers such as hospitals and insurance companies, and the surprising medical care that usually occurs when a patient is treated by a medical professional at a hospital within an insurance network. I urged Congress to end the billing. It’s not. While supporting the elimination of salary tax cuts that fund the program, Trump has promised to protect Medicare for the elderly and some disabled people. His previous budget sought to slow Medicare’s growth rate.

Biden has also proposed using antitrust laws to curb market concentration in the healthcare industry, which he says is pushing up prices. He also advocates stopping astonishing medical bills. He opposes actions that have eroded ACA, such as expanding short-term health insurance. Biden also wants to increase the subsidies available on the ACA exchange.

Write to Stephanie Armor (

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