Clin­ton run­ning as ACA fixer

Modern Healthcare - - POLITICS - —Har­ris Meyer

Hil­lary Clin­ton has been deeply in­volved in health pol­icy since she led the Clin­ton ad­min­is­tra­tion’s un­suc­cess­ful health­care re­form ini­tia­tive in the mid1990s. But as a Demo­cratic pres­i­den­tial can­di­date, she wants to serve as re­form re­pair woman rather than ar­chi­tect, promis­ing to fix the “glitches” in the Af­ford­able Care Act to im­prove ac­cess and af­ford­abil­ity.

She’s also propos­ing to help Amer­i­cans with pre­scrip­tion-drug and in-home care costs and ex­pand fund­ing for Alzheimer’s dis­ease re­search with the goal of find­ing a cure by 2025. And she wants the govern­ment to take steps to curb spi­ral­ing drug costs, in­clud­ing let­ting Medi­care ne­go­ti­ate prices with drug man­u­fac­tur­ers.

But she’s likely to get lots of ques­tions from both her Demo­cratic and Repub­li­can op­po­nents about how she in­tends to pay for those pro­grams, some of which are struc­tured as re­fund­able tax cred­its.

“She’s duck­ing on the cost of tax ex­pen­di­tures, other than vague lan­guage about mak­ing rich peo­ple pay for it,” said Lawrence Jacobs, who stud­ies health­care pol­i­tics at the Univer­sity of Min­nesota. “Hil­lary won’t go into de­tails on how she’ll pay for the pro­grams and im­prove­ments be­cause she doesn’t want to be painted as a tax-and-spend Demo­crat.”

Clin­ton will pro­mote “bite-size” fixes in the ACA and try to avoid big­ger ide­o­log­i­cal fights over health­care, Jacobs said. On the other hand, he pre­dicted that she will at­tack GOP pres­i­den­tial can­di­dates and House Speaker Paul Ryan over their pro­pos­als to con­vert Medi­care into a voucher-like de­fined con­tri­bu­tion pro­gram. “Hil­lary will use the Medi­care changes Ryan clearly has staked out as a way to mo­bi­lize se­niors,” he said, pulling out “the old play­book that Repub­li­cans can’t be trusted” on se­niors’ is­sues.

Hil­lary Clin­ton Po­si­tion Demo­cratic pres­i­den­tial can­di­date Pre­vi­ous po­si­tion U.S. sec­re­tary of state

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