A GOP Debate Primer: Healthcare In The 10 Candidates' Own Words

This political season is unusual in terms of the divergence of views held by the field of 17 GOP candidates. Where they are all unified is in a universal call for the repeal of The Affordable Care Act (ACA), more commonly known as Obamacare. However their moment of unity is fleeting as they diverge again with what should replace it. Here I wanted to take a look at what Trumpcare would look versus Rubiocare or Cruzcare. Our research revealed that there is a general lack of framework and sometimes consistency among the candidates based on their past statements. Of course it’s very early in the campaign season, and, based on some of the information gathered here, it’s certain that policies and opinions will evolve as the field is whittled down. In any event, with two doctors on the stage (Rand Paul and Ben Carson are medical doctors), it will be interesting to see how prominently healthcare plays as a topic for the debates, and how much further the candidates will clarify their positions vis-a-vis Obamacare.

Here are three bullets from each of the 10 debating candidate’s healthcare positions presented in order of their latest polling results:

Donald Trump | Poll: 26%

Donald Trump (Photographer: Victor J. Blue/Bloomberg)

1. Trump once spoke of a single-payer system in his book The America We Deserve, but has recently stated his support for a market-based approach to healthcare reform. He has continued to state that he wants to “take care of everybody.”
2. Trump plans to reduce health insurance costs by increasing competition and allowing insurance companies to compete across state borders. Trump also plans to maintain strong capital controls on these companies to act as a buffer for “catastrophic events.” He has stated that he is open to the idea of government assistance in paying for healthcare.
3. To provide healthcare for low-income Americans, Trump intends to work out “a very, very smart plan with hospitals.”

Jeb Bush | Poll: 15%

Jeb Bush (AP Photo/Jim Cole)

1. Bush has advocated for healthcare reform that involves state-administered subsidies. This system, unlike the Affordable Care Act, would not have mandates and focuses on giving decision-making power to consumers.
2. Bush wants a catastrophic coverage system where the government provides relief for those whose hardship goes beyond their means of paying for it. These plans would cover significant injury more cheaply than comprehensive policies, but would not cover routine medical appointments.
3. During his term as Governor of Florida, Bush changed Florida’s Medicaid program from a defined benefit plan (where states define what medical procedures to pay for) to a defined contribution plan (where states cap the amount they will spend on each recipient).

Scott Walker | Poll: 9%

Scott Walker (AP Photo/Jim Cole)

1. Walker refused to expand Medicaid in exchange for federal money, and instead has proposed a hybrid approach that uses the federal poverty level as the threshold for Medicaid eligibility and provides private-subsidized insurance to those between 100% and 200% of the poverty line.
2. Walker signed a letter asking the Federal government to ease healthcare mandates so that states could have more leeway in crafting healthcare policy. The letter specifically objected to the Maintenance of Effort provisions of the Affordable Care Act, which required states to maintain Medicaid eligibility levels until 2014.
3. Walker has voiced doubts about the ability of the Federal Government to fund the expansions of Medicaid that have occurred in other states.

Mike Huckabee | Poll: 7%

Mike Huckabee (AP Photo)

1. Huckabee has stated that a healthcare system that espouses prevention of disease rather than treatment of it would save lives and save costs. Huckabee wants to reduce costs by preventing expensive chronic conditions.
2. Huckabee has often talked about the problem of obesity and unhealthy lifestyles as a cause of increased healthcare costs, and has even written a book about weight loss titled Quit Digging Your Grave With A Knife and Fork.
3. As an alternative to the Obamacare/ACA, Huckabee wants individual states to test their own healthcare reforms. He also especially opposes the individual mandate provision of the Affordable Care Act.

Ben Carson | Poll: 7%

Ben Carson (AP Photo/Jim Cole)

1. Carson has stated that Obamacare/ACA must be replaced before it is repealed.
2. Carson advocates for Health Savings Accounts (HSAs) as a means to replace Obamacare/ACA and cut healthcare costs. Individuals would have savings accounts to finance their healthcare expenditures. For those unable to contribute to their HSAs, he proposes that federal funding be used to sustain their accounts ($2,000/year) in order to provide them with greater freedom and control over their healthcare.
3. He has stated that his HSA plan would reduce national healthcare spending by 80% down to $630 billion. Carson says his plan would eliminate Medicare and Medicaid.

Ted Cruz | Poll: 6%

Ted Cruz (AP Photo/Jim Cole)

1. Cruz has sponsored the Health Care Choices Act. This act would give individuals the opportunity to purchase health insurance across state borders, allowing for market forces to make competitive options available to citizens.
2. Cruz views the Medicare Part D Drug Program as unconstitutional.
3. Cruz has proposed raising the eligibility age for seniors for Medicare when asked about the rising costs of the program.

Marco Rubio | Poll: 5%

Marco Rubio (AP Photo)

1. Rubio has proposed a healthcare plan that he says could replace the Obamacare/ACA with a system of tax credits, federal coverage for patients with pre-existing conditions and reforms to Medicare and Medicaid.
2. Rubio was one of the key supporters of the effort in 2013 to try to defund Obamacare by causing a government shutdown. According to Rubio, “this is the only chance and the last chance we have” to repeal Obamacare.
3. Ironically, Rubio is actually enrolled in the exchange system. His spokesperson has said, “Senator Rubio spent time looking at all the options and decided to enroll through the D.C. exchange for coverage for him and his family.”

Rand Paul | Poll: 5%

Rand Paul (AP Photo/Jim Cole)

1.  Paul is on the record having said, “With regard to the idea of whether you have a right to healthcare, you have to realize what that implies. It’s not an abstraction. I’m a physician. That means you have a right to come to my house and conscript me. It means you believe in slavery.”
2. Paul said “I was not a member of the United States Senate during the 111th Congress, but if I had been I would have voted against Obamacare. As your President, one of my first acts would be to repeal the abomination that is Obamacare.”
3. Paul has said if Obamacare was repealed, “We could try freedom for a while. We had it for a long time. That’s where you sell something and I agree to buy it because I like it.”

Chris Christie | Poll: 3%

Chris Christie (AP Photo/Jim Cole)

1.  Christie has criticized Obamacare/ACA, calling for its repeal, but Christie expanded Medicaid in New Jersey, citing that he felt that it was best for the state.
2. Christie proposes giving individual states a fixed amount of Medicaid funds indexed to the number of Medicaid enrollees. As a result, states would have the freedom to tailor their Medicaid programs to their citizens.
3. Christie has stated that to contain Medicare spending growth, he will consider means testing. Simply put, those who can afford to pay for health benefits will, while those who are unable to will not.

John Kasich | Poll: 3%

John Kasich (AP Photo/Jim Cole, File)

1.  Kasich has stated, “I’m not for Obamacare. I have expanded Medicaid, because I wanted to bring Ohio dollars back to Ohio.  We’ve been able to apply it to bring significant change, and our ultimate goal is that so all of these people who have been hurt can be in a position to get on their feet and move forward.”
2. Kasich advocates for a $776 billion tax cut plan that he has stated “will help people afford healthcare.”
3. Kasich also defended his stance on expanding Medicaid by saying “The last Republican I can think of who expanded Medicaid was Ronald Reagan.”

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