TW: The first thing [Trump said] he was going to do on day one, was to repeal Obamacare. On day one, he tried to sign an executive order to repeal the ACA. He signed onto a lawsuit to repeal the ACA, but lost at the Supreme Court. And he would have repealed the ACA had it not been for the courage of John McCain to save that bill. So what they're going to do is let insurance companies pick who they insure. That's why the system didn't work. Kamala Harris will protect and enhance the ACA.
JDV: I think you can make a really good argument that it salvaged ObamaCare, which was doing disastrously until Donald Trump came along. I think this is an important point about President Trump. When ObamaCare was crushing under the weight of its own regulatory burden and healthcare costs, Donald Trump could have destroyed the program. Instead, he worked in a bipartisan way to ensure that Americans had access to affordable care.
TRUMP: Obamacare was lousy health care. Always was. It's not very good today. And what I said, that if we come up with something, we are working on things, we're going to do it and we're going to replace it. And what we will do is we're looking at different plans. If we can come up with a plan that's going to cost our people, our population less money and be better health care than Obamacare, then I would absolutely do it. But until then I'd run it as good as it can be run.
Q: So just a yes or no, you still do not have a plan?
TRUMP: I have concepts of a plan. But if we come up with something, I would only change it if we come up with something better and less expensive. And there are concepts and options we have to do that. And you'll be hearing about it in the not-too-distant future.
2010: According to a letter to the editor by J.D. Hamel [Vance's childhood name and social media pseudonym] in the Butler County Journal-News, "Our system has its troubles, but the biggest of them is spending. Because Obama-Care does nothing to reduce the inflationary trend of medical costs, it is an abject failure of a reform package. That's why most conservatives opposed it." [Letter to the Editor by JD Hamel--Butler County Journal-News, 4/8/10]
An op-ed by JD Vance in the Wall Street Journal: "Judge Kavanaugh has come under fire in some quarters of the right for challenges against ObamaCare--in which he aimed to rule narrowly and fairly rather than politically. In one, he dissented from an opinion that upheld the individual mandate. He observed that the individual mandate 'is unprecedented in American history' and cast doubt on its validity under either the Commerce or Taxing clause. " [Wall Street Journal, 7/2/18]
In fact, I'm not only protecting it, I'm expanding it. The enacted tax credits save $800 per person per year, reduced health care cost for millions of working families. That tax credit expire next year. I want to make that savings permanent.
To state the obvious, women are more than half our population, but research on women's health has always been underfunded. That's why we're launching the first-ever White House Initiative on Women's Health Research. Pass my plan for $12 billion to transform women's health research and benefit millions of lives all across America.
Ron DeSantis: We have millions of Americans who do not have access to affordable healthcare, and it's not just getting some type of card and Medicaid, because a lot of times they don't even get access to care. The other thing is we have millions of people that don't have access to good doctors and good hospitals. Florida did not expand Obamacare. I think the states that did that I think are struggling financially. So that, yes, we declined to do that and I don't think that that was the right policy to do, but we are going to go after the cost. You're paying too much for everything. We've actually addressed this in Florida in some ways, but you need price transparency. You need to hold the pharmaceuticals, big insurance, and big government accountable, and we're going to get that done.
PENCE: I think it's one of the choices here. My former running mate, Donald Trump, has a plan to consolidate more power in the executive branch. When I'm president, it's my intention to make the federal government smaller by returning to the states those resources and programs that are rightfully theirs under Tenth Amendment of the Constitution. That means all ObamaCare funding, all housing funding, all HHS funding, all of it goes back to the states. We'll shut down the federal Department of Education. We'll allow states to innovate. We're going to revive federalism in America and states are going to help bring America back.
Vox.com summary:The CA v. TX case was brought by Texas officials who object to ObamaCare, centered on the law's individual mandate [which] required most Americans to either obtain health insurance or pay higher taxes. In 2017, Congress amended ObamaCare to zero out this tax. The Texas plaintiffs claimed that this zeroed-out tax is unconstitutional and also claimed that the entire law must be declared invalid if the zero dollar tax is stuck down. In a 7-2 ruling, the Court ruled that no one is allowed to bring suit to challenge a provision of law that does nothing.
Biden in Reuters:"A big win for the American people," President Joe Biden, whose administration opposed the lawsuit, wrote in a Twitter post, adding that millions of people rely upon the law for healthcare coverage while encouraging others to sign up. Biden has pledged to expand healthcare access and buttress ObamaCare. Biden had criticized Republican efforts to strike down the law during a pandemic.
PROMISE KEPT:(Executive Order on Medicare 1/28/21): It is the policy of my Administration to protect and strengthen Medicaid and the ACA and to make high-quality healthcare accessible and affordable for every American. In light of the exceptional circumstances caused by the ongoing COVID-19 pandemic, establish a Special Enrollment Period for uninsured and under-insured Americans to seek coverage through the Federally Facilitated Marketplace.
OnTheIssues ANALYSIS: Biden made his promise at the beginning of the pandemic, and all healthcare policy in 2021 is tied up with the pandemic. Biden has largely restored ObamaCare cuts--by reopening ACA enrollment--and largely subsidized ObamaCare--via pandemic spending and pandemic justification.
BIDEN: What I'm going to do is pass ObamaCare with a public option, and become BidenCare. The public option says that if you qualify for Medicaid and you do not have the wherewithal in your state to get Medicaid, you automatically are enrolled, providing competition for insurance companies. That's what's going to happen. Secondly, we're going to make sure we reduce the premiums and reduce drug prices by making sure that there's competition, that doesn't exist now, by allowing Medicare to negotiate drug prices with the insurance companies. Thirdly, the idea that I want to eliminate private insurance, the reason why I had such a fight with 20 candidates for the nomination was I support private insurance. That's why. Not one single person with private insurance would lose their insurance under my plan, nor did they under ObamaCare. They did not lose their insurance unless they chose they wanted to go to something else.
TRUMP: We got rid of the individual mandate on ObamaCare. By the way, we're always protecting people with pre-existing conditions, and I can't say that more strongly. The problem with ObamaCare, it's not good. We'd like to terminate it, and we want a much less expensive healthcare that's a much better healthcare.
Q: You repealed, but you haven't replaced. You had the Senate and House in Republican hands, and there is not a replacement yet.
TRUMP: Look, we had both houses and what did we do? We got rid of the individual mandate. That went through the legislature.
Q: But the promise was repeal and replace.
TRUMP: We would like to replace it with something that's much less expensive and much better. We will always protect people with preexisting conditions.
BIDEN: I think that healthcare overall is very much in jeopardy as a consequence of the President's going to go directly after this election directly to the Supreme Court within a month to try to get ObamaCare wiped out after 10 million people have already lost their insurance from their employer and wants to take 20 million people out of the system as well, plus 100 million people with pre-existing conditions.
TRUMP: We got rid of the individual mandate on ObamaCare, and now you could actually say it's not ObamaCare because you had to pay a fortune for the privilege of not having to pay for bad health insurance, so we got rid of that. By the way, we're always protecting people with pre-existing conditions, and I can't say that more strongly. The problem with ObamaCare, it's not good. We'd like to terminate it, and we want a much less expensive healthcare that's a much better healthcare.
TRUMP: That's right, because they want to give good healthcare
Q: Over the last four years, you have promised to repeal and replace ObamaCare, but you have never come up with a comprehensive plan to replace ObamaCare.
TRUMP: Yes, I have. Of course I have. I got rid of the individual mandate, which was a big chunk of ObamaCare.
Q: That's not a comprehensive place.
TRUMP: That is absolutely a big thing. That was the worst part of ObamaCare. The individual mandate was the most unpopular aspect of ObamaCare. I got rid of it. And we will protect people. We guaranteed pre-existing conditions, but took away the individual mandate.
BIDEN: He has no plan for healthcare.
TRUMP: Of course we do.
BIDEN: He has none, like almost everything else he talks about. He does not have a plan.
TRUMP: No, I want to give them better healthcare at a much lower price, because ObamaCare is no good.
BIDEN: He won't ever look you in the eye and say that's what he wants to do: "Take it away." He doesn't know how to do that.
TRUMP: We've already fixed it, to an extent. ObamaCare is no good. We made it better. We guaranteed pre-existing conditions, but took away the individual mandate. I had a choice to make, do I let my people run it really well or badly? If I run it badly, they'll probably blame me. But more importantly, I want to help people; I said, "You've got to run it so well." The problem is, no matter how well you run ObamaCare, it's a disaster. It's too expensive. Premiums are too high, that it doesn't work. So we do want to get rid of it. Chris, we want to get rid of that and give something that's cheaper and better.
BIDEN: I would restore all the cuts this president has made in the Affordable Care Act, across the board. I add what they call a public option, and that is a Medicare-like option. If you wanted to buy into that option or if you didn't have the money, you would be able to get it for free. So it's Medicare if you want it. If you qualify for Medicaid and you don't have it in your state, you're automatically enrolled. There is no waiting for anything.
Secondly, we make sure we reduce drug prices, as well, allowing Medicare to be able to negotiate with the drug companies the cost of drugs. And I would invest over $50 billion to focus on the diseases that cause the most damage and cost the most--cancer, Alzheimer's, and obesity.
We should have a department that says what we're going to do is spend the money needed that the drug companies are unwilling to spend or unable to spend to make sure that we find cures.
In private meeting at the White House, Pence consistently reassured Trump that they would have the votes needed to do away with ObamaCare, create a new healthcare plan, and put a new bill on the president's desk. But Pence's own long time adviser and confidant, Marc Short, consistently delivered a more pessimistic message to Trump, that the votes would be more difficult to come by. Short was right.
BIDEN: I think we should have a debate on health care. I think Obamacare worked. I think the way we add to it, replace everything that has been cut, add a public option, guarantee that everyone will be able to have affordable insurance, number one. Number two, I think we should look at cost. My plan costs $740 billion. It doesn't cost $30 trillion, $3.4 trillion a year, it turns out, is twice what the entire federal budget is. How are we going to pay for it? Thus far, Senator Warren has not indicated how she pays for it.
Sen. Elizabeth WARREN: Pres. Obama transformed health care. Now, how best can we improve it? I believe the best way we can do that is we make sure everybody gets covered by health care at the lowest possible cost. How do we pay for it? Those at the very top, the richest individuals and the biggest corporations, are going to pay more. And middle class families are going to pay less.
NYC Mayor Bill DE BLASIO: I don't know what the vice president is talking about. There's this mythology that folks are in love with their insurance in America. The folks I talk to say that their health insurance isn't working for them.
BIDEN: ObamaCare is working. The way to get to [ten million uninsured Americans] immediately is to build on ObamaCare. Take back all the things that Trump took away, provide a public option, meaning every single person in America would be able to buy into that option if they didn't like their employer plan, or if they're on Medicaid, they'd automatically be in the plan. It would take place immediately. It would move quickly. And it would insure the vast, vast, vast majority of Americans. In the meantime, what happens? Did anybody tell you how much their plans cost? My plan costs $750 billion. [Medicare-for-All costs] $30 trillion.
Biden: My plan makes a limit of co-pay to be $1,000, because we further support the ability to buy into ObamaCare. No one has to keep their private insurance, but if they like their insurance, they should be able to keep it. Nothing is demanded in my plan that there be private insurance. If the 160 million who have it like their employer insurance, they should have a right to have it. If they don't, they can buy into the Biden plan.
Sen. Mike BENNET: Bernie has said over and over again that this [single-payer Medicare-for-All plan] will make illegal all insurance except cosmetic--I guess that's for plastic surgery. Everything else is banned under the Medicare-for-all proposal.
Sen. Bernie SANDERS: You know, Mike, Medicare is the most popular health insurance program in the country.
BENNET: I agree.
SANDERS: People don't like their private insurance companies. They like their doctors and hospitals. Under our plan people go to any doctor they want, any hospital they want. We will substantially lower the cost of health care in this country because we'll stop the greed of the insurance companies. On this issue we have to think about how this affects real people.
Senator BENNET: We need to get to universal health care, by finishing the work we started with ObamaCare and creating a public option.
WILLIAMSON: While I agree with Senator Bennet, it's really nice if we've got all these plans, but we've got to get deeper than just these superficial fixes. We don't have a health care system in the United States. We have a sickness care system in the United States. We just wait until somebody gets sick, and then we talk about who's going pay for the treatment and how they're going to be treated. What we need to talk about is why so many Americans have unnecessary chronic illnesses, so many more compared to other countries. And that gets back into not just the health insurance and big pharma companies, it has to do with chemical policies, it has to do with environmental policies. It has to do with drug policies.
"All Republicans support people with pre-existing conditions, and if they don't, they will after I speak to them," Trump tweeted in October. "I am in total support."
The Trump administration backed Republican-led states in a lawsuit that claims ObamaCare's protections for pre-existing conditions are illegal, and a federal court ruled the law unconstitutional in December. If the Supreme Court confirms the ruling, insurers would be able to start denying coverage to those people. The White House has not proposed alternative legislation that would offer those with pre-existing conditions the protections ObamaCare gives consumers. Supporting the concept of health care for people with pre-existing conditions, and supporting legislation that accomplishes it, are two different things.
SANDERS: You have a Republican leadership in the House and the Senate that tried, came within one vote of throwing 32 million people off of the health insurance they currently have. You have leadership there in the House and the Senate that wants to do away with the preexisting protections that people have in this country. You have a president and Republican leadership who supported a budget which would have cut Medicare by $500 billion.
Q: President Trump argues that Medicare-for-All could lead to worse coverage for many Americans who are happy with their private insurance plan. What do you tell them?
SANDERS: Right now, as a nation, we are spending twice as much per capita on health care as do the people of any other country, $28,000 a year for a family of four. That is unsustainable. 70% of the American people understand that Medicare is a good program, and it should be expanded to all people.
Jeff Johnson (R): Repeal; move toward "a more free-market system."
Tim Walz (D): Support. Opposes attempts to roll back ACA. Believes single payer type system "is on Minnesota's horizon," but need to control immediate costs, improve care, and support MinnesotaCare as best current option. Also supports allowing people to buy into programs like VA system, Medicaid & Medicare.
Ron DeSantis (R): Voted to repeal ACA. No FL Medicaid expansion. Says health care isn't a right. The right is to pursue the type of healthcare you want. ObamaCare infringes on that.
Andrew Gillum (D): Support & strengthen ACA, guarantee care for pre-existing conditions, expand Medicaid in Florida. Work toward "Medicare for all."
A: Yes.
And we are giving our veterans choice in their healthcare decisions.
Gutted? Perhaps. Trump repealed a central pillar of ObamaCare: the "individual mandate," a requirement that Americans obtain health insurance or pay a financial penalty. The law might now experience new problems. But Trump is wrong to claim that he has already "ended" ObamaCare. The individual mandate is a key part of ObamaCare, but it is far from the entire thing. Trump did not touch ObamaCare's expansion of the Medicaid insurance program for low-income people, the federal and state ObamaCare marketplaces that allow other uninsured people to buy insurance, and the subsidies that help many of them make the purchases. Nor did he touch various ObamaCare rules for the insurance market, like its prohibition on insurers denying coverage to people with pre-existing conditions.
This has not happened. Trump issued an executive order on Oct. 12 to ask his Secretary of Labor to propose regulations to allow more employers to make use of "association health plans." But the actual change has not actually been made yet, noted Timothy Jost, an expert on health law as an emeritus professor at Washington and Lee University--so even if millions of people will eventually use these plans, they have, obviously, not been able to do so yet.
Trump added about people joining associations due to changes to ObamaCare, "That's gonna be a big bill, you watch."
The move toward association health plans is not going to be a bill at all, let alone a "big bill." This "would be a change in regulation or guidance," not legislation, Jost noted.
ObamaCare premiums nationwide have increased by double and triple digits. One third of counties have only one insurer on the exchanges--leaving many Americans with no choice at all. Remember when you were told that you could keep your doctor, and keep your plan? We now know that all of those promises have been broken. ObamaCare is collapsing--and we must act decisively to protect all Americans. Action is not a choice--it is a necessity.
Here are the principles that should guide the Congress as we move to create a better healthcare system for all Americans: First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges.
This effort will be guided by two core principles: Buy American, and Hire American. Tonight, I am also calling on this Congress to repeal and replace ObamaCare with reforms that expand choice, increase access, lower costs, and provide better healthcare.
CHRISTIE: I was for repealing and replacing ObamaCare when I was a candidate for president, and I'm still for it now. I hope for a really vigorous, open conversation between the executive branch and the Congress and the nation's governors, since the Medicaid program was 50% funded by our state taxes. And I will certainly share with the administration the experiences we have had here in NJ on the Medicaid program. For instance, five times the number of people are now getting drug abuse treatment in NJ through the Medicaid program than got it three years ago. I think that's a good thing.
CHRISTIE: I want them to continue to be able to have coverage. Now, there can be lots of different ways that that can happen through the repeal and replacement of ObamaCare. And there are great minds inside the Congress and the administration who are going to have ideas on how to do this. President Trump is a deal-maker. And I think he will bring the nation's governors together, since we're stakeholders in this, and make sure that we get something that will take care of the people of the United States. He has always said he does not want a system where people are without health care. We're going to work together to make sure that happens, whether it's through Medicaid or another vehicle.
CRUZ: Bernie and the Democrats want government to control health care. I trust you. And I trust your doctors. I think health care works better when you're in charge of your family's health care decisions.
SANDERS: The Republicans are now in a panic, because the American people have caught on that the absolute repeal of ObamaCare without a plan to make it better, would be an absolute disaster. So when Ted talks about giving people choice, here's your choice. You got cancer, and you go to the doctor, and the insurance company says, "We're not going to cover it. We can't make money on you because you have cancer. You have a pre-existing condition." And here's another choice you can have if we get rid of ObamaCare. If you have diabetes, and you're spending a whole lot, the insurance companies will say, "sorry, we're only going to spend X dollars, because we've got to make money off you." That's the function of private insurance.
SANDERS: No. It's not. But on the other hand, is it fair to not raise the revenue that we need to provide the kinds of benefits that we are providing? That is a way to do it. I don't think it's a particularly good way. I disagree with Ted, who wants to give, according to the "Wall Street Journal" and many other publications, incredible tax breaks to millionaires and billionaires. In the wealthiest country in the world, we should raise funds in a progressive way, where the very rich are now doing phenomenally well--yes, I do believe they should be asked to pay more in taxes and I think we should use that money and other mechanisms to provide health care to all people.
SANDERS: Nobody thinks that ObamaCare is perfect. It has its problems. But every American has got to recognize, we are the only major country on Earth not to guarantee health care to all people. We pay by far the highest prices in the world for prescription drugs because the pharmacy, the pharmaceutical industry is out of control ripping us off. So, what sensible people have got to do is not simply repeal the Affordable Care Act without any alternative, but you've got to sit down and say it's OK, what are the problems. How do we address it? How You just don't throw 20 million people off of health insurance. You don't privatize Medicare.
Q: But if that repeal happens, will you support piecemeal, step by step reforms?
SANDERS: Do we make sure that young people stay on their parents' health insurance? Do we make sure that there are no caps if you're dealing with cancer? It goes without saying that those patient protections have got to stay in place.
I voted for the Affordable Care Act because, while it did not go anywhere near as far as I wanted, it did provide health insurance for about 20 million more Americans, ended the abomination of people being denied insurance coverage because of preexisting conditions, expanded primary health care, and significantly improved health care coverage for women.
Donald Trump: ObamaCare will never work. It's too expensive, and not only expensive for the person that has it, unbelievably expensive for our country. We have to repeal it. We have to get rid of the lines around the state, where we stop insurance companies from competing. We want competition. She wants to go to a single-payer plan, which would be a disaster.
Jill Stein: We need a Medicare-for-all system. 25 percent of healthcare costs are spent on wasteful paper pushing, on CEO salaries, on advertising, on exorbitant pharmaceutical costs like paying $400 for an EpiPen, which contains $1 worth of medication. Under an improved Medicare, that 25 percent overhead is reduced to 1 percent. It enables us to put our healthcare dollars truly into healthcare, so that you are covered, head to toe, cradle to grave.
We have to get rid of the lines around the state, artificial lines, where we stop insurance companies from coming in and competing, because that gives the insurance companies essentially monopolies. We want competition.
You will have the finest health care plan there is. She wants to go to a single-payer plan, which would be a disaster, somewhat similar to Canada. And if you haven't noticed the Canadians, when they need a big operation, when something happens, they come into the United States in many cases because their system is so slow. It's catastrophic in certain ways.
KAINE: Governor Pence doesn't think the world's going so well and he is going to say it's everybody's fault.
PENCE: Do you?
KAINE: Let me tell you this. When Hillary Clinton became secretary of state, Governor Pence, did you know that Osama bin Laden was alive?
PENCE: Yes. [But] at a time of great challenge in the life of this nation, where we've weakened America's place in the world and stifled America's economy.
KAINE: Do you know that we had 175,000 troops deployed in the battlefield in Iraq and Afghanistan? Do you know that Iran was racing toward a nuclear weapon and Russia was expanding its stockpile?
Hillary Clinton wants to have completely government-run health care, which would be a disaster for the liberties and freedoms of all America. That's what she wants. That's what she's aiming at. That's what Obama wanted. He didn't quite get there, but he got this, and you see how bad this has been.
RUBIO: The individual mandate. He said he likes the individual mandate portion of it; I don't believe that should remain there. We need to repeal ObamaCare completely and replace it with a system that puts Americans in charge of their health care money again.
TRUMP: I agree with that 100%, except pre-existing conditions, I would absolutely get rid of ObamaCare. I want to keep pre- existing conditions. It's a modern age, and I think we have to have it.
Q: The insurance companies say is that the only way that they can cover people with pre-existing conditions is to have a mandate requiring everybody purchase health insurance. Are they wrong?
TRUMP: I think they're wrong 100%. Look, the insurance companies take care of the politicians [and vice-versa]. The insurance companies are making an absolute fortune. Yes, they will keep preexisting conditions, and that would be a great thing.
RUBIO: Here's what you didn't hear in that answer. What is your plan? I understand the lines around the state, whatever that means. This is not a game where you draw maps. What is your plan, Mr. Trump?
TRUMP: You get rid of the lines, it brings in competition. So, instead of having one insurance company taking care of New York, or Texas, you'll have many. They'll compete, and it'll be a beautiful thing.
RUBIO: So, that's the only part of the plan? Just the lines?
SANDERS: I think people will support my Medicare-for-All program because the United States today is the only major country on Earth that doesn't guarantee health care to all people as a right. I think the Affordable Care Act has done a lot of good things. But yet we have 29 million people without any health insurance. There are seniors today who cannot afford the outrageously high cost of prescription drugs because in America, we pay, by far, the highest prices in the world for prescription drugs. Last year, while one out of five Americans cannot afford the prescriptions their doctors write, the three major drug companies made $45 billion in profit because they spent hundreds of millions of dollars on lobbying and campaign contributions. I believe, as a principle, everybody should be entitled to health care as a right, comprehensive health care.
Clinton argues we can simply expand the Affordable Care Act to achieve universal coverage, which we view as impossible. Sanders is on target with his new Medicare-for-all proposal. However, by preserving the illusion that the ACA is a "step in the right direction," Sanders misses the point that the current U.S. health care system under the ACA is unique among industrialized nations because it treats health care as a commodity rather than a public good.
CLINTON: The Democratic Party worked since Harry Truman to get the Affordable Care Act passed. I don't want see us start over again with a contentious debate. I want us to defend and build on the Affordable Care Act & improve it.
SANDERS: Her campaign was saying "Sanders wants to end Medicare." That is nonsense. I'm on the committee that wrote the Affordable Care Act. What a Medicare-for-all program does is finally provide in this country health care for every man, woman and child as a right. Now, the truth is: FDR and Truman, do you know what they believed in? They believed that health care should be available to all of our people. What we have to deal with is the fact that 29 million people still have no health insurance. My proposal: provide health care to all people, get private insurance out of health insurance, lower the cost of health care for middle class families by $5,000.
CHRISTIE: I expanded Medicaid because it was right for New Jersey, because I had had three liberal Democratic governors before me, and so in expanding Medicaid we actually made money in New Jersey and lowered our costs in emergency rooms across the state.
TRUMP: A complete disaster, yes.
Q: Saying it needs to be repealed & replaced.
TRUMP: Correct.
Q: Now, 15 years ago, you called yourself a liberal on health care. You were for a single-payer system, a Canadian-style system. Why were you for that then and why aren't you for it now?
TRUMP: As far as single payer, it works in Canada. It could have worked in a different age. What I'd like to see is a private system without the artificial lines around every state. I have a big company with thousands of employees. And if I'm negotiating in BY or NJ or CA, I have like one bidder. Nobody can bid. You know why? Because the insurance companies are making a fortune because they have control of the politicians. They're making a fortune. Get rid of the artificial lines and you will have yourself great plans. And then we have to take care of the people that can't take care of themselves. And I will do that through a different system.
Stein: The answer is a Medicare-for-All system. Much of what motivates large settlements is the need to pay for a lifetime of chronic care. With healthcare as a human right, you no longer need to go to court to assure coverage.
OnTheIssues: How would you implement that, given that ObamaCare is here to stay?
Stein: New Zealand uses no fault malpractice insurance--there is no requirement to find intention or fault-- and no need to create a villain when dealing with just statistical risks--and they have much smaller settlements. That is something we might want to look into, but the definitive answer is Medicare-for-All. Court settlement is an important safeguard against abuse and incompetence--that right should not be curtailed--but no-fault and Medicare-for-All is the main answer. If there are to be any changes in the way the courts work, the focus should be on speeding up the process.
A: You know, I looked at that. I looked at it very seriously. Some people don't agree with me on this: I want everyone to have coverage. I love the free market, but we never had a free market. Even before ObamaCare, it wasn't really free market. As an example, in New York, when I wanted to bid out my health insurance, we had boundaries. I could only go in New York. If I wanted to bid it out to a company from California or New Jersey, anywhere--you get no bids.
Q: But the single payer, you're not interested anymore?
A: No. No, these are different times. And over the years, you are going to change your attitudes. You're going to learn things and you're going to change. And I have evolved on that issue. I have evolved on numerous issues.
Speaking at the Iowa Freedom Summit in January, Trump said ObamaCare is a catastrophe that must be repealed and replaced. In 2011, Trump suggested that the health insurance industry have more ability to cross state lines. In "The America We Deserve" Trump wrote that he supported universal healthcare and a system that would mirror Canada's government-run healthcare service.
Sanders voted for the Affordable Care Act, but believes that the new health care law did not go far enough. Instead, he espouses a single-payer system in which the federal and state governments would provide health care to all Americans. Participating states would be required to set up their own single-payer system and a national oversight board would establish an overall budget.
Scott: Disagree
Question topic: The Affordable Care Act (ObamaCare) should be repealed by Congress.
Scott: Strongly Agree
But as a state, and as an elected government, we will not be victims in this process. We rejected the federal government's less than generous offer to run a state exchange, an offer that would have Washington bureaucrats dictating the exchange and South Carolinians paying for it.
And, with your help, we emphatically said no to the central component of ObamaCare, the expansion of a broken Medicaid program that is already cannibalizing our budget, and would completely destroy it in the years to come.
These were not decisions made lightly, without thought or analysis. But I am fully convinced that South Carolina will be better for them, and I pledge to you this: we will continue to fight ObamaCare every step of the way.
RUBIO: Well, here is the distinguishing factor. Under ObamaCare, when you turn Medicaid over to the states what you're saying to them is the money will be available up front for the expansion for a few years, then the money will go away but you get stuck with the unfunded liability. I'm not saying we should do that. I'm actually saying that what we should do is take the existing federal funding that we use for some of these programs, and we're still working through which ones those should be, collapse them in to one central federal agency that would then transfer that money to fund innovative state programs that address the same issues. But it would be funded, it wouldn't be something where states are told you get the money for a few years then we'll back away. And it should be revenue neutral.
HUCKABEE: It ought to be a priority. But the priority should have been to deal with 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, as much as anybody will ever be satisfied with insurance. What we should have done is something that was comparable to what was done back 1982, Ronald Reagan signed a bill that was called TEFRA, the Tax Equity Family Relief Act. In the Arkansas TEFRA program we took people who had severe developmental disabilities, for example, there's no way a family can afford that. But the only way for them to qualify for Medicaid would be to impoverish the family. Well, that doesn't make sense. So, what we should say is it's going to be reasonable premium, a reasonable deductible, and a reasonable co-pay, then the government would subsidize those people whose medical expenses are extraordinary.
"Under the ACA, all Americans have the right to access affordable, quality healthcare, including contraception. For-profit companies should not be able to deny women access to healthcare based on the religious beliefs of the company's owners. The 10th circuit ruling should be reversed by the US Supreme Court."
The list of ObamaCare exemptions includes one on religion: anyone who is "conscientiously opposed to accepting any insurance benefits," which some say includes Muslim groups. This portion of the law was apparently written specifically for the Amish, but it may play a role in the fight over ObamaCare.
CHRISTIE: Anybody who has run anything in their lives could see this coming a mile away. And that's why we didn't do a state based health exchange. We didn't do it because we could see that this whole program was going to be a problem. So let's own up, tell the truth about what's going on. Then they can worry about working something out to fix the problem--not working out of a fantasy that these are not major problems. Lots of us have been saying all along about the fact that this was just too big for the government to handle.
Q: You didn't set up an exchange, but you did accept the expansion of Medicaid under ObamaCare.
CHRISTIE: I do what's best for the people of New Jersey every day. And expanding Medicaid in N.J. was a relatively small expansion. It's going to benefit N.J.'s budget.
CHRISTIE: I think ObamaCare was a mistake. And I've said that right from the beginning. I think it's a failed policy. That's why we did not institute state-based exchanges. And you could see exactly why when you see the disaster that's happening right now. The fact of the matter is the president didn't tell folks the truth about what was going to happen with their own private insurance policies. And what I urged them to do, is tell people the truth. That's the thing they expect. And I think that's why we've gotten the support we've gotten in NJ. Because whether it's good news or bad news, I tell folks in NJ the hard truth they need to hear. And even when they disagree with me, they've come around to support me. Because they say at least this guy is looking us in the eye and telling us the truth. I think the president failed that test, unfortunately, on ObamaCare.
The fact is, ObamaCare is expected to cause millions of uninsured Americans to gain health insurance, not lose it. Rubio's office points to a Congressional Budget Office report that said 27 million of the uninsured would have coverage by 2017.
Rubio's claim about some people losing "health insurance they were happy with" references the CBO's estimate that the number with employer-sponsored coverage would decline by 7 million by 2017. That's a net reduction, with some workers gaining coverage, some losing it, and others deciding to obtain other insurance on their own.
But these are estimates for what the insurance landscape will look like in the future. People aren't "now . losing the health insurance they were happy with," as Rubio said. In fact, CBO's estimates show 2 million uninsured Americans gaining coverage this year.
STEIN: We are squandering trillions of dollars over the coming decade on a massive, wasteful health insurance, private health insurance bureaucracy. By moving to a single-payer, Medicare-for-all system, we get a system that people love and want to defend from government tampering, and that system covers everyone comprehensively, puts you back in charge of your healthcare, and, in addition, it actually saves us trillions over the coming decade, equivalent to that austerity plan that they were talking about. What we have right now is 30% of every healthcare dollar is being spent on bureaucracy, red tape and paper pushing. Under Medicare, that 30% shrinks down to 2% to 3%. That's enough to cover everybody. And we deserve that.
BIDEN: No religious institution, Catholic or otherwise, including any hospital--none has to refer contraception. None has to pay for contraception. None has to be a vehicle to get contraception in any insurance policy they provide. That is a fact.
RYAN: If they agree with you, then why would they keep suing you? It's a distinction without a difference.
STEIN: Both Obama and Romney-Ryan are both aiming for essentially for the same targets. For Medicare, they are both aiming for Medicare to be reduced to about 2.2% of GDP. A sign that things are not really different between these two corporate-sponsored candidates. They're both proposing about $700 billion in Medicare cuts. We can fix this. One thing we can do right now is to fix Medicare Part D so that it's no longer a boondoggle, a giveaway for pharmaceutical companies and to allow bargaining and negotiation to get bulk purchasing and bring down the cost.
ANDERSON: The solution to Medicare is to provide Medicare for everybody. To make it a single payer system.
STEIN: I live in the state of Massachusetts. So, I've seen RomneyCare or ObamaCare--take your pick--the Affordable Care Act actually in the flesh is neither affordable nor caring, because it provides stripped-down plans which are fairly expensive unless you are in a very low income. If you are making less than $20,000 a year as a family, you're covered. And it actually has expanded care for the very poor, and that is a good thing. But if you're in the $20,000-$40,000 bracket, near-poor, these plans cover about 70% of your costs; yet you are paying approximately 10% of your income for them. So, it's not affordable for families. You're not fully covered. The proof of the pudding here is that when people get sick in Massachusetts now, they go into medical bankruptcy just as much as they did before we had the Affordable Care Act.
We have good services, but we need to educate people on how to better utilize them and on how to pay more attention to their health.
I told Obama that his health-care plan imposed mandates that South Carolina just couldn't afford. Our annual budget is $5 billion, and we had calculated that his plan would cost us $5 billion over the next 10 years. We expected to see 30% to 40% of our private companies drop their employees' coverage and force their workers into the public system. My question had 2 parts, I told the president. Would he repeal Obamacare? And if not, would he allow South Carolina to opt out of the system?
I had pledged, as governor, to lead a coalition of governors to fight Obamacare and allow the states to offer real solutions to our health-care crisis. I was dead set against Obamacare, but Sheheen wanted to have it both ways. Pressed on the issue in the debate, he claimed to support some parts of the Obama plan but not others. There were "good and bad" parts of the bill, he insisted.
"Senator, you can't split the cow," I replied. "You can't say you like certain parts of it and not other parts. We're stuck with the whole cow."
Sheheen's answer was petty and insulting, even for him. "We need a governor with the intelligence and the ability to say when things are good and things are bad," he said. He was calling me unintelligent! The crowd got it and booed the cheap shot.
I have been consistent as a candidate and as governor in my position to Obamacare. The president's approach is wrongheaded and unconstitutional. He's pouring more costs into the system through federal mandates instead of taking costs out of the system through transparency and individual responsibility.
But there is one bright side to the president's plan: It has sparked a conversation about health care that is badly needed. Our healthcare problem is real. In South Carolina we have a large Medicaid population, and health care is the main driver of our budget deficit. But our health-care problem is also unique to our state--it's not the same as the health-care challenges in states like MA or NE. Our challenges are mainly poverty and education.
A. Small time, sure. There are minor improvements. But on the other hand, he took single-payer off the table. He absolutely took a public option off the table. And how about bringing Wall Street in, the guys who created the problem, among his first appointments. It was pretty clear right then that this was going to be business as usual on steroids. We're certainly more equitable, or more healthy, with what Obama has brought.
A: Well, we have it in Massachusetts, since it's really modeled after RomneyCare, and it's very problematic. It is not a solution--it did extend care to some people who didn't have it, but kind of at the cost of working families. The costs are not fairly distributed; the mandate is extremely unfair; the system is entirely unsustainable, and it is not working. Many people say health care is worse than it is better under ObamaCare, which is remarkable because you don't know what the real problems of a health care system are until you get sick.
Q: Was ObamaCare a step forward?
A: I think it was a step backward for the final goal of a system of single payer health care.
Q: So do you support ObamaCare?
A: I don't support ObamaCare and see it as a step backward that entrenches the power of the private health care industry.
Obamacare is a heat-seeking missile that will destroy jobs & small businesses; it will explode health-care costs; and it will lead to health care that is far less innovative than it is today. Every argument that you'd make against socialism you can make against socialized health care, and any candidate who isn't 100% committed to scrapping Obamacare is not someone America should elect president. Repealing Obamacare may be one of the most important and consequential actions our next president takes.
In his CPAC speech, Trump sounded many themes popular with Republican conservatives. "I am pro-life," he said. "I am against gun control."
And in one of his biggest applause lines, Trump vowed to end the nation's health care law: "I will fight to end Obamacare and replace it with something that makes sense for
PENCE: We are going to use every means at our disposal to oppose this government takeover of health care. I think the American people see a headlong rush to confront the very real challenges that we have in health care with more government instead of more freedom. Republicans have been offering solutions from the beginning. Let people purchase health insurance across state lines, pass malpractice reform, cover preexisting conditions. All of that can be done without a massive, trillion-dollar expansion of the federal government and burdening future generations with more deficits and more debt.
Q: But the reality is that you don't have the votes to stop it politically.
PENCE: A minority in Congress plus the American people equals a majority. The American people don't want this government takeover of health care. And I don't know if they have the votes today, but I guarantee you, the American people know they have the votes in America.
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