Candidates running on health care reform
But paths to get there divert on policy nuances
A standard blood test can cost as little as $56 or as much as $492.
Nearly one in five Texans does not have health insurance.
Three in 10 patients report delaying treatment because of the costs.
Two-thirds of Americans who file for bankruptcy say health care costs are to blame.
There are plenty of signs — like these — that U.S. health care is broken. That’s why reform is expected to be a major issue in this year’s presidential election.
With Super Tuesday days away, candidates are trying to win over voters in 13 states, including Texas. Every major Democratic candidate is running on a platform that includes a health care overhaul to improve access and drive down costs for millions of families struggling to keep up with their medical bills
Vermont Sen. Bernie Sanders sits on the liberal end of the political spectrum. He’s running on a
“Medicare for All” platform, which means he wants to replace the current multi-payer health care system with a single government-administered plan.
No more networks, premiums, deductibles, copays or surprise bills. The proposed coverage would include medical, hearing, dental, vision, mental health, prescription drugs and much more.
Sen. Elizabeth Warren of Massachusetts is also pushing Medicare for All, although she’s offered up a detailed transition plan for getting there in a few years by increasing taxes on the wealthy and asking employers to pay a bigger share to the government.
The cost of Medicare-for-All plans has long been a concern. Sanders estimates his plan would cost anywhere from $17 trillion and $40 trillion over 10 years. Warren estimates her single-payer plan that would cost an estimated $20.5 trillion over 10 years.
Not so fast
Former South Bend, Ind., Mayor Pete Buttigieg and other moderates in the race take a slower approach to universal health care, without driving private insurance companies out of business — at least for the time being.
Former Vice President Joe Biden wants to revamp the Affordable Care Act by lowering out-of-pocket costs and expanding coverage. Biden would allow the public — even those who could receive insurance through their employers — to purchase plans on the government’s marketplace, including the 1.5 million uninsured adults in Texas affected by the state’s refusal to expand Medicaid.
Texas is one of 14 states that opted not to expand Medicaid, with many adults, including those without children, falling into a “coverage gap.” They have incomes above Medicaid eligibility limits but not below the poverty level, which would make them eligible for a discount on premiums.
Sen. Amy Klobuchar of Minnesota wants to expand access to ACA plans and make them more affordable. But she doesn’t say how much she would increase federal subsidies that help cover the cost of premiums.
Election Day is March 3. Polls are open from 7 a.m. to 7 p.m.
Both Biden and Buttigieg say the way to increase access is to lower the income cap for tax credits. Both candidates say families shouldn’t spend more than 8.5 percent of their income on health insurance.
Currently, a family can spend as much as 9.8 percent of household income on health insurance before becoming eligible for discounted health plan premiums on ACA.
A family of three with an annual income of $31,000 — that would have paid $1,200 a year for a “silver plan” through the federal marketplace — would instead pay $600 a year for a higher-quality gold plan, according to Buttigieg’s campaign website.
Mike Bloomberg, former mayor of New York City, offers a “Medicare-like” public option that would also cap premiums at 8.5 percent of household income. Bloomberg proposes driving down pharmaceutical costs by capping drug prices at 120 percent of the average cost in other advanced nations. His plan bans drug company payments to pharmacy benefit managers, which are third-party firms that negotiate the price of medications covered by insurance plans. Pharmacy benefit managers have long taken part of the blame for rising drug costs.
Big worries
Policy nuances aside, Democratic presidential candidates all contend Trump is mishandling health care, including his efforts to dismantle the ACA, such as backing a lawsuit to strike down the federal insurance mandate in the Supreme Court.
His opponents also take issue with Trump allowing the sale of short-term health plans that don’t have to comply with ACA regulations, such as the requirement to cover preexisting conditions, and his attempt to eliminate funding for reproductive care.
Trump has also worked to restrict health care access to immigrants and removed protections for LGBTQ people.
“The concept of having universal health care, or that health care is a human right, is not a hard sell,” said Michelle Tremillo, executive director of the Texas Organizing Project, a progressive advocacy group whose members are mostly black and Latino families. Tremillo said the Texas Organizing Project’s members endorsed Sanders for president mainly because of his plan to overhaul the health care system.
A recent University of TexasAustin/Texas Tribune poll found that 70 percent of Texas Democrats prefer universal health care over the current health care system
“The system as it currently exists does not work and actually denies our communities access to health care, even if they have insurance,” Tremillo said. “They aren’t going to the doctor when they are sick.”