The Five Healthcare Issues That Will Dominate the 2016 Election

September 28, 2015


Is Donald Trump’s hair real or fake? Is Hillary Clinton’s server clean or not? We’re as fascinated by these questions as anyone else and will debate these questions and more in our next blog post.

As we trudge through September, October and then another 12 months until the election, we’ve begrudgingly accepted that the political media circus will continue unabated. There will be more questions about Hillary’s emails, Joe Biden’s intentions, Chris Christie’s waistline, Marco Rubio’s sweat glands and so many more fun topics that will dominate the Twitterverse.

Putting aside the political entertainment, the candidates are beginning to lay the groundwork to address major health care policy issues for the coming election. Over the next 13-plus months, candidates will stake out their positions on the way Americans get and pay for healthcare, who pays the bills and what role the government should play in determining all of it.

Here are five issues we’ll be watching closely and analyzing as we head into an election year:

  1. Affordable Care Act: Amend it, end it, or a bit of both? It’s been five years, but the debate over Obamacare hasn’t stopped in Congress, the courts or the media. As long as President Obama is in the Oval Office, that won’t change. But what happens when his tenure ends? Republicans will seek to strengthen their majorities in both houses of Congress and hope a new Republican President can fulfill their pledge to repeal the ACA. Yet by the time our next President takes the oath of office, it’s likely that 15-20 million Americans will have Obamacare coverage, meaning repeal won’t be nearly as cut and dried. If a Democrat is elected, she or he will have to work with Congress to find ways to improve the law by getting rid of certain elements both parties dislike – medical device taxes, Cadillac insurance plan tax and maybe the employer mandate.
  1. Drug Prices. Martin Shkreli may be the latest poster boy for critics of high drug prices, but the issue was bubbling long before he bought the patent to Daraprim and raised the price from $18 to $750 per pill. In August, the Kaiser Family Foundation released public opinion poll results showing 72 percent of Americans think drug prices are too high. Clinton and Sen. Bernie Sanders rushed out their plans to regulate drug prices, proposals that have been made before and rejected by both parties of Congresses. Industry leaders recognize they have a P.R. problem and will have to do a better job of making their case to the public and politicians.
  1. Reproductive Health. The firestorm over Planned Parenthood is just the latest in a battle that has been raging for more than 40 years. While states have taken a number of steps to limit access to abortions, Congress has remained stalemated over enacting federal laws to do so.
  1. Healthcare Entitlements. The two parties have divergent views of entitlement programs like Medicare and Medicaid. Jeb Bush took heat for saying the current Medicare construct should be “phased out” while Christie has suggested cutting off benefits for wealthy retirees. Clinton, Sanders and other Democrats talk of expanding Medicare. The sharper differences are over Medicaid, where most Republicans call for turning the entitlement into a state-run block grant program with a fixed federal contribution and Democrats pressing for further expansion of coverage to those living just above the poverty line.
  1. Opioids and Heroin. It’s not often that national debates change direction, but the current discussions over drug treatment for people addicted to painkillers is one example. Clinton and Christie have declared the 30-year War on Drugs a failure, and thoughtful proposals are emerging to expand access to treatment, all while finding a delicate balance between restricting misuse of opioids without pushing more people living with pain towards illegal substances.

Richard Sorian contributed to this post.