Republican candidates: Healthcare views at a glance

November 16, 2015

Managed Healthcare Executive has sorted through the platforms of the Republicans running for president to tell you where they stand on healthcare issues.

Do you know where the Republican candidates stand on key healthcare issues? To provide some answers, Managed Healthcare Executive sorted through their platforms and asked experts closely watching the race to weigh in.

Scroll through the slides to see where each candidate stands.

 

 

 

Senator Rand Paul

Believes that it is Congress’ job to fight to change Obamacare and that Obamacare is still unconstitutional, despite Supreme Court ruling; it is Congress’ job to oversee spending; if a program is too costly, then it’s Congress’ job to modify the program; opposes the Christian Coalition’s (CC) survey question on government-run healthcare; signed the Contract from America in which candidates pledged to defund, repeal, & replace federal care with free market.; signed Club for Growth's "Repeal-It!" Pledge to repeal any federal healthcare takeover.

 

 

 

Governor John Kasich

Not in favor of Obamacare, but expanded Ohio’s Medicaid expansion under the Affordable Care Act; in Ohio shifted funding from nursing homes to home-based care; expanded programs for the mentally ill, fought the nursing home lobby to bring down Medicaid costs; opposes the CC survey question on government-run healthcare; signed a letter with from 32 Governors to President Obama asking the federal government to loosen "one-size-fits-all" approach to Medicaid.

“Ohio has taken Medicaid from 10% to 2% growth without cutting benefits or number of enrollees,” says Joseph M. Mack, MPA, president, Joseph Mack & Associates, a managed care and value-based consultant. “Cost cuts have resulted in Ohio’s surplus.”

 

 

 

Ben Carson, MD

Instead of the technocratic behemoth of Obamacare, empower the individual; believes that a two-tiered system of healthcare works; believes in stiff penalties for medical fraud:; believes that government should regulate insurance companies as non-profit services; believes that government should be responsible for catastrophic event insurance, which would lessen the burden on insurance companies and enable a more reasonable premium.

 

 

 

Donald Trump

Believes in a private system without the artificial lines around every state; believes the ACA should be repealed and replaced; formerly wrote that he supported universal healthcare and a system that would mirror Canada's government-run healthcare service; doesn’t believe in cutting Medicare,  grow the economy to keep benefits; believes ACA plan deductibles are too high “that it’s useless.”

“Finding the right balance for a new shift in healthcare to get our country back on the right track for a Republican remains a key challenge for the Washington outsiders as much as the insiders,” according to Randy Vogenberg, PhD, partner with Access Market Intelligence and the National Institute for Collaborative Healthcare in Greenville, South Carolina.

 

 

 

Governor Jeb Bush

Believes that Obamacare is “flawed to its core and doesn’t work”; believes the ACA is focused on access rather than quality; wants to move Medicaid from "defined benefit" to “defined contribution”; believes in state’s rights and adopted National Governor’s Association position that the Employment Retirement Income Security Act (ERISA) is the greatest single barrier to many state reform and patient protection initiatives

“The Bush plan is the most detailed of any of the proposals. It focuses on reducing waste by expanding efficiency and giving beneficiaries additional choices. This is not a rehash of premium support, but a full-blown program modernization that leverages the latest data and technology to drive down costs. It is impressive in that it seeks to bring to fee-for-service Medicare what has been lacking to date: a reason to improve. The lower cost, more beneficiary-focused, the better a provider or plan will do under the model. That is impressive,” according to Joel White, president of the Council for Affordable Health Coverage

“Bush's plan is poised to heal Obamacare-inflicted wounds,” White continues. “The ACA has made life extremely difficult for small businesses. In making the case for his replacement plan, Bush argued that ‘It costs small businesses more to comply with Obamacare's myriad new rules than it does to insure a worker.’”

“On top of that, the Obama administration is now fining small businesses that offer their workers money to help them pay for insurance or other out-of-pocket healthcare expenses-on the grounds that these ‘health reimbursement arrangements’ don't comply with Obamacare,” White says.

“Fortunately, Bush's proposal addresses the affordability concerns of individuals and businesses alike,” White continues. “Bush would first roll back Obamacare's many cost-inflating coverage mandates. That would allow individuals and businesses to buy lower-cost catastrophic policies if they'd like.

According to White, individuals without employer-sponsored plans would receive tax credits to help offset the cost of coverage. “Older Americans would receive larger credits, since they tend to have higher medical expenses and thus face higher premiums,” he says. “Small businesses in particular would be allowed to give their workers tax-free lump sums to purchase coverage on the individual market.”

 

 

 

Governor Chris Christie

Believes the ACA is a poorly created program; expanded Medicaid under the ACA, but did not set up an exchange; signed a letter from 24 Governors to Congress in support of a 3.2% funding increase for National Institutes of Health; also signed a letter from 32 Governors to President Obama requesting the loosening of a "one-size-fits-all" approach to Medicaid.

“Christie believes in eliminating entitlements for seniors making over $200,000, including Social Security,” according to Mack.

 

 

 

Senator Ted Cruz

Believes that the government shutdown on Obamacare worked: GOP won in 2014; believes that Medicare must be saved by gradually increasing the eligibility age and by moving to a premium support system that expands choices for seniors, opens up innovation, and utilizes market forces to rein in healthcare costs; supports the CC Voters Guide question to repeal Obamacare, and the CC Voters Guide to support market-based health insurance; signed the Contract From America to defund, repeal, and replace government-run healthcare; signed Club for Growth's "Repeal-It!" Pledge.

 

 

 

Carly Fiorina

Believes the ACA needs to be repealed; opposes the CC survey question on government-run healthcare (doesn’t support government-run); signed Club for Growth's "Repeal-It!" Pledge.

 

 

 

Governor Mike Huckabee

Believes the ACA should have focused on the 15% of people who didn't have insurance rather than disrupt the system for the 85% who did and who were largely satisfied with insurance; believes the idea of first-dollar coverage for healthcare for all expenses defies common sense; believes the focus should be on preventing the illness rather than disease treatment; believes that each individual consumer should make their own healthcare choices, not government; opposes mandated health insurance and universal coverage.

“Huckabee believes that the focus should be on prevention and curing the four big chronic diseases: Alzheimer’s, diabetes, heart disease and cancer. Preventing and curing these diseases will save billions of dollars,” Mack says.

 

 

 

Senator Marco Rubio

Supports providing states funding for innovative major poverty programs like healthcare; believes in expanding mental health centers; believes capitated managed care plans achieve better value; opposes the CC survey question on government-run healthcare; signed the Contract From America to defund, repeal and replace government-run healthcare; signed Club for Growth's "Repeal-It!" Pledge.

“Rubio has said that he thinks that ‘everyone on the state is not advocating for changing Medicare for current beneficiaries, but in the future,’” Mack says.  He said his plan would be for those over 55 years of age.”

 

 

 

Senator Lindsey Graham

Opposes the ACA and voted to repeal it and introduced legislation giving states the option to opt out.

 


 

 

Senator Rick Santorum

Wants to repeal Obamacare; wants to change Medicaid to Block Grant System; introduced initial Health Savings Account legislation; wants to allow individuals to buy pre-tax insurance like companies do.

“Voters have yet to be convinced that any of the Republican candidates can help to fix the country’s broken healthcare system. With Obamacare being implemented, the time has passed for the law to be repealed.  The candidate who develops a healthcare plan to work within the structure of Obamacare will be best positioned for success, according to John Santilli, partner with Access Market Intelligence and the National Institute for Collaborative Healthcare in Greenville, South Carolina.