Similarities and Differences in the Trump and Biden Healthcare Positions

The Democrats held their national convention last week, and this week the Republicans follow suit. To help see the forest for the trees for these two weeks, here’s a quick summary of where both President Donald Trump and Joe Biden stand on healthcare policy. 

We’ll start off easy: the Patient Protection and Affordable Care Act (PPACA) figures prominently in the approaches to healthcare for both campaigns. If you look at the White House’s official page on healthcare and Biden’s formal campaign platform, the PPACA is mentioned in the first sentence of both.

The Trump Administration has been and is trying to overturn the PPACA, and in fact, the U.S. Supreme Court announced last week that it will hear the administration’s challenge to the law on Nov. 10, 2020 – that is, a week after the election. In the meantime, President Trump has promised he will soon release his own healthcare plan. One of the Republican Party’s primary issues with the PPACA, including its Medicaid expansion, was that it was federally driven. Republicans in general felt that the states should have more control over healthcare policy. President Trump’s expected healthcare plan will likely reflect this state-centric approach. 

Biden, as part of the Obama Administration that passed the law, would like to see the PPACA strengthened and broadened.

The key element in the Biden healthcare platform is a public health plan option, built on the PPACA, that would available to all, even if your employer offers healthcare benefits. The plan would be modeled after Medicare in how it negotiates lower prices from providers, but Biden has made it clear that his public option is not “Medicare for all:” it is not a single-payer system that would replace commercial insurance.

One of the pillars of the PPACA is protection for people with preexisting conditions. President Trump has said that he supports that element of the PPACA, and in fact, he has signaled that he may sign an executive order on preexisting conditions in the coming days.

The two candidates have other common healthcare goals. Trump’s and Biden’s respective approaches to lowering the cost of prescription drugs are very similar. Both also support a prohibition on surprise balance billing of patients, though neither give details on how surprise out-of-network provider reimbursement should be managed. Both campaigns have also put forward plans to battle the opioid crisis, although the strategies have significant differences.

Enough kumbaya: other differences include Biden’s goal of addressing anti-trust issues by looking at the market concentration in healthcare systems; no specific details on that yet. Trump, for his part, has been very focused on healthcare cost transparency. Cost transparency has not figured prominently in Biden’s platform.

Lastly, the two differ on their approach to the current pandemic. According to his platform, Biden envisions greater national control over the response, including developing more prescriptive guidelines governing public and private businesses reopening.

President Trump has spoken about the successes his administration has had in fighting the pandemic and its economic impact. In contrast to Biden’s platform, Trump has tended to leave more control to the states to decide how to respond and manage government reaction to the pandemic. 

In this pandemic, discussions about healthcare take place almost daily in our homes; healthcare issues and policies saturate the media. We all know more about vaccine development and contact tracing than we ever cared to know. In this environment, over the coming weeks, the two candidates will have to persuade a well-informed electorate of their respective healthcare approaches.

Programming Note: Matthew Albright is a permanent panelist on Monitor Mondays. Listen to his legislative update sponsored by Zelis, Mondays at 10 a.m. EST.