Originally published September 1, 2016,
last updated September 16, 2016
Medicare's Fate Under the Next President
By Brian Hickey, Vice President of Insuractive®
As the Nov. 8 election nears, more details are emerging on the presidential candidates’ stances on important retirement issues such as Social Security and Medicare.
We’ve sifted through the information to give you a summary of what Democratic nominee Hillary Clinton and Republican nominee Donald Trump say they’ll do if elected. But ultimately, the fate of these government entitlements depends not solely on the president, but also on the partisan makeup of Congress and how its members will work with the new president.
On the surface, it appears both Clinton and Trump want to preserve Social Security and Medicare. But they do differ on what that means.
In May, Reuters reported that Trump advisor Sam Clovis said Trump would consider potential entitlement cuts: “I think after the administration’s been in place, then we will start to take a look at all of the programs, including entitlement programs like Social Security and Medicare.”
Clinton has more detailed specifics on Medicare. She opposes privatizing or phasing out Medicare, and her new “Medicare for More” program would allow people older than 50 or 55 to buy into Medicare. With more people opting in, costs could be distributed more widely; although critics argue that the program could further burden the Medicare system by adding sickly patients.
Clinton opposes privatizing or phasing out Social Security. She is against raising the retirement age or cutting annual cost-of-living adjustments.
Just as Trump’s position on Medicare goes against the GOP’s, so does his stance on Social Security. The GOP wants to privatize the Social Security system; Trump has said “It’s my absolute intention to leave Social Security the way it is.” He says his broader economic policies — bringing back jobs, for example — will grow the economy, generate the tax revenue and provide the savings necessary to keep the program solvent.
As of now, I am not sure there is a clear winner between Trump and Clinton when discussing health care and Social Security. As with many issues, Trump unfortunately gives very little information on what he will propose specifically with Medicare, but does outline some items under the umbrella of “health care.” Clinton does have more specifics on what she would propose for both Medicare and Social Security, but her solutions do not come without problems as well.
Let’s look at some of the specifics:
- Clinton wants to expand the Affordable Care Act (ACA), and Trump opposes it. On the surface, expanding health care to people under age 65 and continuing to allow a scenario in which people do not have to medically qualify seems like a great idea. Unfortunately, we are currently seeing the ramifications of this now as insurance carriers are increasing rates drastically across the country and in many situations are actually leaving the market all together.
- Clinton proposes to allow more people on Medicare and lower the age to 55. Again, on the surface this may seem promising, but the devil is in the details. Over the past few years, we’ve seen an increase in physicians no longer accepting Medicare. Some physicians do not agree with the fees they are being paid by the federal government and in those situations turn away people with Medicare. Should we expand Medicare, I anticipate that we will see an increase of doctors refusing to accept Medicare — which will in turn increase the time it takes to get in to see a doctor who does accept Medicare.
- Clinton proposes to expand Social Security and help pay for the increase by taxing people with income over $250,000. Expanding Social Security could be a great thing, or it could eventually lead to the downfall of the entire system. The question becomes: is there is a concrete actuarial model that shows actual dollars in versus dollars out? Is there a way to show sustainability for decades upon decades with only increasing taxes on those earning $250,000 or more, or will there be other targets to pay for the expansion?
- Repeal the Affordable Care Act
- Allow plans to be sold across state lines
- Allow individuals to fully deduct health insurance premiums
- Health Savings Accounts (HSAs) — passed on to heirs and used by any family member
- Price transparency from doctors and hospitals to allow consumers to shop
- Remove federal oversight from Medicaid funding
- Allow consumers the ability to purchase imported medications legally
- Enforce immigration laws prohibiting health care usage by illegal immigrants
- Has said he won’t cut Social Security, but advisors recently hinted of possible cuts
- Defend and expand the Affordable Care Act
- Allow people 55+ to buy into Medicare
- Reduce cost of prescription meds
- Expand Medicaid
- Expand access to health care regardless of immigration status
- Defend access to reproductive health care allowing affordable contraception, safe/legal abortions
- Expand Social Security benefits for those who “need it most and who are treated unfairly today,” including caregivers who leave the workforce to look after children or sick family members, and widows who face steep benefit cuts when their spouses die
- To pay for expanding Social Security and keeping it solvent, would increase taxes on those earning more than $250,000 a year