How the presidential race could affect uninsured rates, out-of-pocket costs

The state of health care would look dramatically different under a Hillary Clinton presidency than it would under Donald Trump, according to a new report from the Commonwealth Fund and the RAND Corporation.

Their comparison of the two major candidates’ health plan said the biggest impacts would be seen in the uninsured rate and out-of-pocket costs thanks to their vastly different takes on the Affordable Care Act (ACA).

If Clinton enacted her proposal to cap out-of-pocket costs at 5 percent of income, for example, the study said up to 9.6 million more people would gain insurance coverage by 2018. The price tag of that proposal, however, would be $90 billion.

Other proposals which the study said would have measurable impacts by 2018 would be offering tax credits to limit premium costs to 8.5 percent of income (would increase coverage by 1.7 million people, cost $3.5 billion) and adding a public option for ACA exchanges (400,000 more people would have coverage, could lower deficit by $700 million).

Trump’s biggest impact on health care would be felt if he was successful in repealing the ACA. The study said 19.7 million people would lose their insurance coverage, average out-of-pocket costs on the individual market would rise to $4,700 and the budget deficit would increase by $33 billion.

Similar effects are predicted for many of his other proposals, like permitting insurers to sell plans across state lines (17.5 million people would lose coverage, deficit increased by $33.7 billion), changing Medicaid to a block grant program (25.1 million would lose coverage at cost of $500 million) or making all insurance premiums tax deductible (15.6 million would lose coverage at cost of $41 billion).

The study didn’t measure the impact of every healthcare proposal the candidates have put forward. For example, it doesn’t predict the results of Clinton’s plan to “expand value-based delivery system reform in Medicare and Medicaid” or Trump’s plan to allow imported prescription drugs for personal use.

Notably, Trump doesn’t offer any proposals on several topics, including employer-sponsored insurance, Medicare reforms or long-term care.

You can read the full comparison here.

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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