Last month, both parties held their 2020 conventions. In addition to the pageantry associated with formally nominating the presidential candidate, conventions have traditionally served as a time to solidify the party platform ahead of the election.
During the Democratic National Convention, Senator Kamala Harris (D-CA) was nominated as the Democrats’ candidate for Vice President and delegates officially approved the 2020 Democratic Party Platform. The largely symbolic document provides additional details about the party’s healthcare policy positions, many of which were already outlined in the recent Biden-Sanders Unity Task Force Recommendations. Notably, the platform lays out additional details for achieving Vice President Biden’s vision of universal healthcare coverage, including clarifying that the proposed public option will be administered by the government through the Centers for Medicare & Medicaid Services (CMS) and outlining a commitment to empowering states to develop tailored coverage initiatives through waivers, removing barriers for states seeking to experiment with statewide universal healthcare approaches.
Ahead of the Republican National Convention, President Donald Trump and Vice President Mike Pence released a high-level overview of their second-term agenda, including reducing healthcare costs and ending surprise billing. At the convention, the Republican Party made the unusual decision not to issue a new platform, and instead reissued the same platform it used in the 2016 race. It is unclear whether the party or the President will release additional details about the Republican platform—specifically a long-awaited healthcare plan—in advance of the presidential debates, which are scheduled to kick off on September 29.
With the election less than two months away and the country continuing to grapple with the COVID-19 pandemic, the debates are likely to focus on healthcare-related issues. According to a recent Pew study, 68% of voters say healthcare will play an important role in determining which candidate they choose—and 62% say the coronavirus pandemic will be a key factor in driving their decision in November.
Manatt Health provides an updated infographic comparing the key healthcare policy positions of President Donald Trump and former Vice President Joe Biden.
- Healthcare Reform. Biden has proposed a new federal public option plan, increased Marketplace subsidies and a Medicare eligibility expansion to Americans over 60 years old. Trump campaigned on repealing and replacing the Affordable Care Act (ACA), and the Trump Administration supports overturning the ACA.
- COVID-19. Both candidates have released COVID-19 response plans outlining policy and guidance for accelerating testing, treatment and economic recovery. However, Trump and Biden differ with respect to the role of the federal government versus state governments in responding to the epidemic, and on steps to facilitate economic reopening.
- Prescription Drug Pricing. Both candidates have made prescription drugs a focus of their healthcare agenda, with slightly different areas of emphasis. Biden’s prescription drug pricing policies focus on Medicare negotiations and restricting price increases. The Trump Administration has proposed a range of administration actions and is supporting legislative efforts to reduce prescription drug prices and redesign the Medicare Part D benefit, although few have been finalized to date.
- Substance Use Disorders and the Opioid Crisis. Both candidates have outlined their support for policies to hold pharmaceutical companies accountable for negligence and to fund local public health interventions. Biden has proposed decriminalizing drug offenses and increasing mental health resources, while Trump has focused on securing borders to reduce the supply of illicit drugs.
- Health Equity. The COVID-19 pandemic has laid bare the urgent need to address racial health disparities, with recent data showing age-adjusted mortality rates over three times higher for black (3.6), indigenous (3.4), Latino (3.2) and Pacific Islander (3.0) populations, compared to white Americans. Biden has provided plans to improve disparities across geography, race and ethnicity; the Trump Administration has largely focused on rural health needs.
When reviewing the candidates’ positions, it’s important to note that presidential platforms are largely aspirational and policy positions often evolve once candidates take office. In addition, while the candidates can make campaign promises now, legislation is required for the majority of major healthcare reforms proposed by Biden and Trump. The makeup of Congress will impact how much of the President’s agenda is actually enacted into law and whether the Congress has the power to stop the President’s administrative agenda by derailing nominations, holding oversight hearings and overturning rules. Additionally, courts can thwart administrative and legislative actions, as we have seen with the continued litigation over the ACA and administrative actions, such as approval of work requirements.