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Health policy issues and the 2016 presidential election

Alice M. Rivlin and Robert D. Reischauer

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SUMMARY:

Focusing specifically on health care, the Urban Institute’s Robert D. Reischauer and Brookings Senior Fellow Alice M. Rivlin write that there are three main health care issues the candidates should focus on. First, on the Affordable Care Act, the GOP must have a detailed plan to “replace” the ACA if they repeal it, while Democrats should go beyond ACA defense and a technical corrections bill to focus on some alternative to the IPAB, possible elimination of the employer mandate, and a restructuring of the Cadillac tax, as well as other modifications. Second, while health care spending has recently moderated, that is expected to end soon; thus both parties must focus on ways to slow down its growth. Third, because Medicare has no legal authority to run a deficit and thus would have to cut spending, the candidates need to take action now to shore up its Trust Fund, which Reischauer and Rivlin say will be difficult since “even more than Social Security, [Medicare] is the third rail of American politics.”

“There are of course other health policy issues that the next president will have to address… But the issues we have focused on in this paper … are likely to dominate election debate. If the candidates present realistic proposals and explain them well, the campaign can be a constructive step toward crafting future health policy solutions. If the candidates mainly bash each other and talk vaguely about panaceas they cannot defend, the public will be confused and it will be harder for the next administration and Congress to work together to improve health policy,” they conclude.

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