Well, it’s official. The 2024 presidential election will be a re-match of 2020: Joe Biden vs. Donald Trump. The current and former president have each captured their party’s nomination and will once again face off in November. And that has some wondering how a potential victory by President Biden or President Trump would impact health care and health insurance. While this might not be the number one concern of voters, it’s always high on the priority list. For brokers, it’s important to understand the priorities because, one way or another, our industry will be affected. And, between now and November, we’re likely to get questions from clients.

For a glimpse into the two candidates’ positions, we took a look at President Biden’s recent State of the Union address and a February JAMA Health Forum article on Trump's potential health care agenda. Here’s a summary:

Biden's Health Care Agenda

President Biden delivered the State of the Union address March 7, 2024. In it, he focused on a few issues important to millions of Americans: prescription drug costs, Medicare reform, the premium tax credits available to people who purchase coverage in the individual market, and abortion rights.

Prescription Drug Costs and Medicare Reform: President Biden emphasized the significance of the Inflation Reduction Act (IRA) in his address, highlighting its role in enabling Medicare to negotiate drug prices directly with pharmaceutical companies. This move aims to replicate the Veterans Affairs system's efficiency, projecting substantial savings for taxpayers by reducing the federal deficit by $160 billion. Furthermore, the IRA introduced significant reforms to Medicare Part D, including the elimination of the five-percent coinsurance requirement and a cap on out-of-pocket expenses, benefiting the elderly and low-income individuals.

Strengthening the ACA and enhancing the Premium Tax Credits: The Biden administration has actively worked to reinforce the Affordable Care Act (ACA) by restoring funding for consumer assistance and outreach, which had been cut by nearly 90 percent during the Trump administration. This effort, coupled with increased premium tax credits, has led to record enrollment in ACA Marketplace plans. Biden also advocates for making these increased premium subsidies permanent, a move that would require congressional approval.

Reproductive Rights: In President Biden's State of the Union address, he fervently articulated his stance on reproductive rights, highlighting the critical importance of abortion access and in-vitro fertilization (IVF) as fundamental aspects of healthcare and family planning. He shared stories of individuals affected by restrictive laws, emphasizing how such regulations not only impede on women's health and autonomy but also on the aspirations of families across the nation. Biden's position underscores a commitment to safeguarding reproductive freedom and ensuring that IVF remains accessible to all who dream of starting or growing their families. By advocating for the restoration of Roe v. Wade and calling on Congress to protect and guarantee reproductive and family planning rights nationwide, President Biden has positioned himself as a staunch defender of reproductive health and freedoms, highlighting the stark contrasts in policy and principle from his predecessor's administration.

Trump's Health Care Vision

The Trump campaign has not released detailed policy outlines and his statements to the public are often broad.. However, looking at his previous term as president and his recent statements as a candidate, we can get an idea of how Trump might handle health care policy and how his approach may differ from President Biden's.

ACA and Medicaid Funding: During his time in office, President Trump aimed to dismantle the ACA, succeeding partially by repealing the individual mandate penalty and making significant cuts to consumer assistance funding. His administration also supported an unsuccessful lawsuit to overturn the ACA entirely. Trump's budget proposals as president included plans to convert the ACA into a block grant to states and cap federal funding for Medicaid, potentially reducing federal health care funding by over $1 trillion over a decade.

Prescription Drugs and Health Care Services: Trump has expressed a desire to tackle the high prices of prescription drugs and health care services. His administration initiated a demonstration program to cap monthly co-pays for insulin for some Medicare beneficiaries at $35 and issued regulations for states to import lower-priced drugs from Canada. However, the broader impact of these efforts on drug pricing remains uncertain. Trump's previous and current comments suggest potential for bipartisan cooperation on drug pricing and transparency.

Abortion and Reproductive Health: Trump's appointments to the Supreme Court paved the way for the overturning of Roe v. Wade, significantly impacting abortion rights in the U.S. Despite this, Trump has been noncommittal about supporting a nationwide abortion ban and has critiqued overly restrictive state laws. His stance contrasts with Biden's call to codify abortion rights into federal law.

Immigration Policies and Health Care Access: Trump's anti-immigration stance, characterized by policies aimed at restricting health care access for immigrants, contrasts sharply with Biden's approach..

Final Thoughts

The health care policies of Joe Biden and Donald Trump offer contrasts in vision and impact. Biden's approach focuses on strengthening the ACA, expanding Medicare, reducing prescription drug costs, and protecting reproductive rights. In contrast, Trump's tenure and potential future presidency might prioritize ACA repeal efforts, restrict abortion and family planning access, and implement policies that could limit health care access for immigrants. As America approaches another election, these differences highlight the significant impact presidential policies can have on the nation's health care system.