2020 election: Trump and Biden diverge sharply on health care

Voters are already heading to the ballot box in droves to choose between President Trump and former Vice President Joe Biden, and the issue of health care has become a key issue.

At the core of the candidate’s divergence on health care policy is the Affordable Care Act (ACA), otherwise known as Obamacare. President Trump wants to completely repeal and replace the health care law, while Biden prefers to build upon and refine the existing law.

Trump and Biden have different visions for health care. (Graphic: David Foster/Yahoo Finance)
Trump and Biden have different visions for health care. (Graphic: David Foster/Yahoo Finance)

Here’s a look at the details of the individual policies:

Affordable Care Act

Biden

Biden wants to build upon the ACA by offering a public option, automatically enrolling qualified people onto Medicaid in non-expansion states, increasing premium subsidies, and lower premiums.

Trump

President Trump has made clear that he wants to repeal the ACA but has yet to offer a comprehensive plan should the ACA be overturned by the Supreme Court and millions of Americans lose their health insurance.

“What the president put out was well short of a plan,” Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, told Yahoo Finance. “On the highest profile issue of protecting people with pre-existing conditions, the president promised to continue those protections if the ACA is overturned. But he’s offered no details about how he would do that.”

U.S. President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, in Washington, U.S., May 4, 2017. REUTERS/Carlos Barria
U.S. President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act to repeal major parts of Obamacare, Washington, U.S., May 4, 2017. REUTERS/Carlos Barria

And despite Trump’s vow to use an executive order to maintain protections for millions of Americans pre-existing conditions, experts are skeptical.

“It is the employer that is actually the big insurer,” Wendell Potter, a former executive for Cigna, told Yahoo Finance. “So an executive order can’t touch all that, can’t require companies to do something.”

Expert notes

Prior to the ACA, Potter said, “it was a “horrible, horrible world” in which 15 million people in the country didn’t have health insurance. As the leader of corporate communications for Cigna at the time, Potter had a message to convey.

“I was supposed to make people believe that wasn’t such a big problem, that a lot of people were uninsured by choice,” he said. “I was expected to leave out this very important point: That many of those people were not able to buy insurance at any price because they had a preexisting condition.”

LANCASTER, PA - JUNE 25: Democratic presidential candidate former Vice President Joe Biden speaks during an event about affordable healthcare at the Lancaster Recreation Center on June 25, 2020 in Lancaster, Pennsylvania. Biden met with families who have benefited from the Affordable Care Act and made remarks on his plan for affordable healthcare. (Photo by Joshua Roberts/Getty Images)
Democratic presidential candidate former Vice President Joe Biden speaks during an event about affordable healthcare at the Lancaster Recreation Center on June 25, 2020. (Photo by Joshua Roberts/Getty Images)

Medicaid

Medicaid comes with a high price tag, accounting for 16% of total national health expenditures in 2018 at $597.4 billion.

The Supreme Court ruled that it was unconstitutional for states to be forced into expanding Medicaid, declaring that it should be left up to the states to decide. Currently, there are still 12 states that have not adopted the Medicaid expansion. The rates of uninsurance in those states are significantly higher than the rest of the nation.