Where presidential candidates stand on health care

GLENN ELLIS | 10/28/2016, 1:36 p.m.
In the moments before President Barack Obama prepared to sign the health care reform law that would forever define his ...
President Barack Obama signs the ACA health care bill in the East Room of the White House in Washington, March 23, 2010. J. Scott Applewhite

Strategies for Well-Being

In the moments before President Barack Obama prepared to sign the health care reform law that would forever define his domestic legacy, Vice President Joe Biden famously whispered into his ear, “This is a big [expletive] deal.”

The future of the Affordable Care Act – sometimes referred to as Obamacare – depends on the election of the next president and could shape Obama’s presidential legacy.

Democrats and Republicans agree on very little when it comes to the future of the U.S. health system. But what both sides have in common is the prioritization of health as a campaign issue in this 2016 presidential race. Numerous reports have found that, in spite of the implementation of the ACA, Americans continue to pay more for their health care than any other developed country, but see some of the worst health outcomes.

For sure, the ACA has helped improve the lives of millions who previously were unable to access the healthcare system, but this help has made many wonder about the “affordable” part of the Affordable Care Act.

Proposed rate hikes are just starting to dribble out, setting up a battle over health insurance costs in a tumultuous presidential election year that will decide the fate of the ACA. Many consumers will see large rate increases for the first time Nov. 1 – a week before they go to the polls.

The last thing Democrats want to contend with just a week before the 2016 presidential election is an outcry over double-digit insurance hikes as millions of Americans begin signing up for the ACA.

But that looks increasingly likely as health plans socked by ACA losses look to regain their financial footing by raising rates.

If three of the nation’s largest insurers can’t make it on the ACA exchanges, can anyone?

That’s the question hanging over Obama’s signature health reform law less than three months before enrollment begins for 2017.

The consensus among insurance experts is that the ACA shakeout isn’t fatal – that is, not unless political leaders decide to make it so. Many insurers – including Anthem, with Blue Cross Blue Shield plans in 14 states, and Centene, the nation’s largest Medicaid insurer – remain committed to the ACA marketplaces despite their dismal financial performance.

In three of the last four election cycles, health care has been a major issue. In 2008, Senator Barack Obama advocated for health care changes on his way to the presidency. Then, Republicans scored historic congressional gains by successfully pushing back against the president’s ACA in 2010. And in 2014, Republicans took the Senate in part because of public disaffection with the rollout and implementation of the ACA. Of all the issues debated by the Trump and Clinton campaigns, few offer a clearer picture of the candidates’ philosophical differences than health care coverage. While Hillary Clinton says her goal is to preserve and build on the ACA, Donald Trump has made clear his intention is to repeal current legislation and replace it with a system that requires less federal government support.