U.S healthcare reform balances on election results

When the Affordable Care Act (ACA), or Obamacare, was signed into law by president Obama in October 2010, approximately 42 million Americans went without health insurance. By the end of the first year of the program, that number had significantly dropped to just over 30 million. However, the ACA, which seeks to control insurance and pharmaceutical costs and improve access to Medicare, has split the country in two since its conception, just as it divides the candidates in the upcoming presidential election. Hillary Clinton and Donald Trump have both outlined their widely different approaches to healthcare reform in the U.S, managing to swing to entirely opposite ends of the spectrum while still apparently aiming for the same goal; that of reducing healthcare costs for U.S citizens.

Healthcare for everyone

Hillary Clinton’s left-field position on healthcare has been decided for decades, so it came as no surprise when she announced her plans to expand the ACA; working towards a healthcare system that would eventually mirror those currently found in countries such as the UK or Canada. This, in turn, would hand the choice back to the citizens and increase competition with private insurers, hence lowering prices. Clinton intends to do this by using tax credits and implement new procedures for states to block increases on insurance premiums. Clinton also strives to extend healthcare protection to undocumented Americans, who represent the most vulnerable contingency of the population. However, if the house remains a GOP majority, it is unclear how many of these objectives Clinton will be able to get passed.

More liberty from state legislation

On the other side of the field, Donald Trump would repeal the ACA, in accordance with the wishes of most Republicans, but has yet to stipulate how it will be replaced. He has expressed the idea of allowing insurance companies to sell across state lines, claiming that this will lower insurance costs as it will increase competition. However, experts have refuted these claims by pointing out that insurers licensed by one state could sell insurance elsewhere, potentially allowing them to bypass the laws in other states. As there is a lot of variation in state law on health insurance, this would enable insurers to handpick the states which grant them the most flexibility for risk management. Therefore, citizens in certain states may get lower premiums but prices for those in others may rise exponentially. With the repeal of the ACA, overall this would probably mean less people are able to afford coverage under Trump’s proposals.

Corporations vs. the state

Furthermore, with the upcoming consolidation of major private health insurance companies, by the end of 2017 only three corporations will control 70% of the healthcare market which in itself will mean some drastic changes to the healthcare market, no matter who wins. These major corporations are currently working closely with hospitals and providers to increase company profits; taking certain medical services further out of the control of the state. Therefore, the future president will have to monitor this lobbying while trying to determine the future of the ACA and work towards decreasing healthcare costs at the same time. 

New era for healthcare

So no matter which way the vote lies come November 8, one thing’s for certain- U.S citizens should expect great changes to their healthcare policies in the coming years. Clinton’s plans to expand the ACA will undoubtedly benefit those on lower incomes and secure healthcare for millions, whereas Trump’s proposals offer security only to the rich, promising to lower prices but with no guarantee. Either way, there will be significant alterations to the management of health care policies thanks to the consolidation of insurance companies, and the future President will have to take this into account when it comes to drafting new legislation. Yet in spite of the candidates opposing views on healthcare reform, they both agree on one thing- there are still plenty of changes that need to be made.

Image: Rich Girard