Comparing Trump and Biden-Harris Health Policies: Costs and Choices Examined

October 25, 2024

Upon his inauguration in January 2017, President Donald Trump was confronted with a U.S. health care system plagued by rapidly escalating premium costs. Between 2010 and 2017, the cost of premiums for family plans under employer-sponsored insurance surged by 36%, a figure that far outstripped the rate of inflation, which increased by about 12% during the same period. This dramatic rise in health care costs underscores the urgency and magnitude of the issues facing the American populace, necessitating a robust response from the Trump administration aimed at making health care more affordable and accessible for all.

Trump’s Approach to Health Care Reform

One of the hallmark strategies of Trump’s health care reform was dismantling barriers that prevented small businesses and individual workers from banding together to purchase health insurance. By enabling small employers, freelancers, and the self-employed to form association health plans, Trump aimed to pool resources and negotiate lower premiums that were traditionally available only to large corporations. The Congressional Budget Office projected that these measures would result in premium reductions of up to 30%, compared to traditional small employer plans, and would extend coverage to approximately 3.7 million individuals by 2028. This initiative was an attempt to leverage collective purchasing power to bring down costs and make insurance more accessible to a broader swath of the population.

Another significant reform under the Trump administration was the expanded flexibility in Medicare Advantage (MA) plans, particularly targeting seniors with chronic conditions who require specialized care. By granting these plans the ability to offer tailored benefits, the Trump administration sought to improve the quality of patient care while simultaneously cutting down costs for crucial services such as diabetes management visits and other routine check-ups. These changes were designed to grant seniors better, more responsive care aligned with their specific health needs, potentially leading to both improved outcomes and lowered overall expenditure for chronic care management.

Prescription Drug Policy Changes Under Trump

The Trump administration took substantive steps to make prescription medications more affordable by adjusting the framework of Medicare Part D. By accelerating the approval process for generic drugs, which are generally less expensive than their brand-name counterparts, the administration aimed to increase competition and drive down prices. This was achieved by reducing the notification window required before insurers could start covering generics, resulting in a notable expansion in the availability of Medicare Advantage plans. From 2017 to 2021, the number of MA plans increased by 78%, while average monthly premiums saw a significant decline of 34%. The impact was also apparent in Medicare Part D, which experienced a 34% rise in the number of plans and a 19% decrease in premiums during the same timeframe.

These policy changes were intended to provide beneficiaries with more options and more affordable alternatives, thereby enhancing patient choice and flexibility. The overarching trend under Trump’s administration was to foster an environment where health care options were plentiful, premiums were lower, and medications were more accessible. This approach aimed to mitigate the financial burden on beneficiaries while improving access to necessary treatments and services, contributing to an overall more responsive and cost-efficient health care system.

Biden-Harris Health Care Policy Overview

In stark contrast to the Trump administration’s deregulatory approach, the Biden-Harris administration has pivoted back towards increased government intervention in the health care marketplace. The passage of the American Rescue Plan Act in 2021 stands as a quintessential example of this shift. The act funneled a substantial sum of money into Obamacare’s insurance subsidy program, aiming to increase affordability and expand access. According to the Congressional Budget Office, however, this influx of funds has significantly contributed to rising medical inflation, with a reported 15% increase in medical-related inflation since the act’s enactment, as noted by the Bureau of Labor Statistics. Critics argue that this act, while well-intentioned, has inadvertently exacerbated cost pressures within the system, thereby undermining its intended purpose of reducing expenses for health care consumers.

The Biden-Harris administration also enacted the Inflation Reduction Act of 2022, which implemented sweeping changes to Medicare Part D. This piece of legislation dramatically altered the financial landscape, leading to a projected 37.7% increase in annual costs borne by taxpayers and patients. Analysts predict that expenditures will surge from $109.7 billion in 2021 to $151.1 billion by 2025. Additionally, the number of Medicare Part D plans is expected to decrease by 47%, potentially impacting around 2 million seniors by 2025. This legislative overhaul is viewed by detractors as a move that limits options for consumers while simultaneously escalating costs, further complicating the health care landscape for many Americans.

Impact on Cost and Coverage Choices

The policies implemented under the Biden-Harris administration are seen by critics as not only driving up health care costs but also significantly restricting the breadth of choices available to consumers. Whereas Trump’s tenure was marked by efforts to enhance flexibility and reduce costs through initiatives such as association health plans, Medicare Advantage improvements, and prescription drug plan adjustments, the Biden-Harris measures have been accused of reintroducing regulatory complexities and fostering higher expenses. Bobby Jindal and Charlie Katebi argue in their critique that Trump’s policies facilitated an increase in consumer choice and a reduction in health care costs, whereas the Biden-Harris policies have effectively rolled back these gains.

According to Jindal and Katebi, policies like the American Rescue Plan and the Inflation Reduction Act have led to not only higher premiums but also a decrease in the availability of diverse health care plans. They contend that the substantial financial injections into the system, coupled with increased regulation, have created an environment where affordable health care is more elusive, and options are more limited. This critique underscores a fundamental disagreement over the role of government intervention in achieving optimal health care outcomes, with the authors favoring market-driven solutions over federally mandated subsidies and regulations.

Comparative Analysis of Health Care Outcomes

When President Donald Trump took office in January 2017, he faced a significant challenge with the U.S. health care system. Premium costs for insurance were skyrocketing, creating intense pressure on American families. From 2010 to 2017, the cost of premiums for employer-sponsored family plans shot up by an astonishing 36%. In contrast, inflation rose by only about 12% during the same period. This disparity highlighted a critical problem—health care was becoming increasingly unaffordable for many Americans, far outpacing the general cost of living.

The dramatic rise in health care costs underscored the urgency for the Trump administration to take meaningful action. Making health care more affordable and accessible became a paramount issue. The situation called for comprehensive strategies to address this growing concern, necessitating reforms to ensure that health care did not continue to drain American household budgets disproportionately. Tackling these challenges was essential for improving the well-being and financial stability of millions of Americans, making it one of the top priorities for the administration.

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