Here's Where Donald Trump and Hillary Clinton Stand on Healthcare Issues

Typically, when we evaluate candidates for the U.S. presidency, we look at their track record as a politician, as well as the plans they’ve proposed should they become president. This year’s election, however, requires us to look beyond past political precedent as the Republican candidate, Donald Trump, has never held any government office. Because a thorough analysis requires us to compare the lives of Hillary Clinton, who has 30 years of political experience, to Trump, whose experience lies within his brand and business, comparison may, at first glance, seem unfair.

The Mighty took a look at the issues that affect voters with disabilities, mental illnesses, rare diseases, neurological differences like autism, and chronic conditions and pulled together both candidates’ platforms, statements and plans, to create a comprehensive guide for those planning to vote in the 2016 presidential election.

Here is where Hillary Clinton and Donald Trump stand on the issues of health insurance; disability rights; mental illness; autism; medical marijuana, opioids and addiction; reproductive rights; and healthcare services for veterans.

Health Insurance

When the Affordable Care Act (ACA), or, as it’s more commonly known, Obamacare, was passed in 2010, it set up a marketplace that allowed individuals to buy health insurance and created a number of healthcare provisions meant to protect Americans, meaning:

• Insurers can no longer deny you coverage based on any pre-existing conditions you may have.
• Young people, those under the age of 26, can stay on their parent’s insurance plan.
• It’s easier for millions of people to qualify for and enroll in Medicaid, allowing people who haven’t been able to afford their own coverage to enroll in a government-based program.
• Women can no longer be charged a higher premium than men.

The next president will likely decide the fate of the ACA. Neither Donald Trump nor the Republican party support Obamacare. Both Trump and the GOP are calling for a full repeal of Obamacare, meaning the 20 million Americans covered under the ACA would lose their coverage.

During the second presidential debate, when asked if his alternative to Obamacare would protect people with pre-existing conditions, Trump replied, “You’re going to have plans that are so good, because we are going to have so much competition in the insurance industry once we breakout the [individual state] lines that allow the competition to come… But when we get rid of those lines, you have competition, and we will be able to keep pre-existing, and also be able to help people who don’t have money because we are going to have people protected.”

Since the debate, no further details have been provided as to how competition protects people with pre-existing conditions. Without being required to cover people who have or have had health problems, it is unlikely insurers will be generous with their offerings. We have begun to see this already with insurers like Humana, Aetna and UnitedHealth leaving the marketplaces set up by the ACA because they did not realize the pool of people looking for insurance would be so sick and therefore expensive to cover.

The full repeal of Obamacare is one of the main points of the Trump campaign, with Trump’s campaign website stating Trump will ask Congress for a full repeal of the act on his first day in office. The plan he prepares to replace Obamacare with predominantly offers federal and state-based financial reforms, which he says will lower healthcare costs for all Americans. Reforms include:

• Eliminating the mandate that everyone must have health insurance.
• Setting up a system that allows health insurance vendors to sell plans across state lines.
• Allowing individuals to deduct their health insurance premiums from their taxes.
• Promoting the use of health savings accounts (HSAs), especially for young people and those with high-deductible insurance plans.
• Requiring price transparency from all healthcare providers, so patients can shop around for low-cost services.
• Letting individual states decide how their Medicaid programs will run.
• Removing barriers for drug providers, meaning people can import prescription drugs from overseas.

Democrats support keeping Obamacare, with Hillary Clinton proposing, during the same debate, fixing what’s broken about the act, rather than throwing it away. Clinton’s plan to fix Obamacare includes:

• Allowing people 55 and older to buy into Medicare.
• Bringing down out-of-pocket costs for items like copays and deductibles.
• Reducing the price of prescription medications and protecting people from prescription drug price increases.
• Incentivizing states to expand Medicare so more lower-income families qualify.
• Expanding affordable healthcare to rural areas, including promoting telehealth.
• Expanding healthcare coverage regardless of immigration status.
• Doubling funding for community health centers.
• Defending access to reproductive healthcare for women.

Disability Rights

Hillary Clinton has a long standing history of supporting those living with disabilities. After law school, Clinton went to work for the Children’s Defense Fund, where her work gathering evidence regarding school attendance among children with disabilities resulted in the passage of a law ensuring all children with disabilities have access to an education. As first lady, Clinton advocated for and helped pass the Family Medical Leave Act. Clinton’s plan to improve the lives of Americans with disabilities includes:

• Working to fulfill the promises of the Americans with Disabilities Act.
• Expanding support services, so disabled Americans can be fully immersed in their communities.
• Helping people with disabilities find meaningful jobs.
• Providing tax relief to those who care for aging relatives or family members with chronic illnesses or disabilities.

Clinton also wants to guarantee up to 12 weeks of paid family and medical leave, as well as ensure those taking a leave of absence receive at least two-third of their wages while away. According to her campaign’s website, her plan imposes no additional costs for businesses. Instead it will be paid for by tax reforms for wealthy Americans.

Donald Trump has no policies – neither spoken nor stated on his campaign’s website – that address or protect people with disabilities. His track record promoting accessibility and interacting with the disabled community includes the following:

• Trump Hotels have been sued at least 12 times for violating the Americans With Disabilities Act.
• In 2015, at a rally in South Carolina, Trump allegedly mocked Serge Kovaleski, a reporter for the New York Times. Trump imitated Kovaleski, who has arthrogryposis, saying “You got to see this guy” and flailing his arms. Trump denies he imitated the reporter.
• In 1999, Trump took medical funds away from his great-nephew, who was born with cerebral palsy, after his nephew sued Trump from excluding his family from Trump’s father’s will.
• In 1988, Trump flew a sick toddler from Los Angeles to New York, after the toddler’s father, a rabbi, called Trump asking to borrow his private jet. Trump did not know the rabbi or his family.

Mental Illness

Approximately 40 million Americans live with a mental health condition, 14 million of whom have with a serious mental illness such as bipolar disorder and schizophrenia. In a brief shared on her campaign’s website, Hillary Clinton outlines six areas her administration would focus on, including:

• Improving mental health diagnostics and treatment for postpartum mothers, children and college students, as well as a national initiative to address and prevent suicide.
• Ensuring physical and mental health care are treated equally by improving the quality and accessibility of mental health care.
• Improving criminal justice outcomes by training law enforcement officers in crisis intervention and prioritizing treatment over jail for low-level, nonviolent offenders.
• Enforcing the Mental Health Parity and Addiction Equity Act of 2008, a bill co-sponsored by Clinton which states that mental health benefits under group insurance plans should be equal to those afforded to other medical and physical health conditions.
• Increasing housing and job opportunities for people living with mental illnesses, as well as promoting advocacy and support programs.
  Providing funding for more brain and behavioral research, as well as developing new partnerships between public, private and nonprofit sectors.

Clinton also plans to increase funding for Alzheimer’s disease, stating we can prevent, treat, and cure Alzheimer’s by 2025.

Donald Trump does not have a specific plan to address mental illness. His plan, as detailed on his campaign’s website, states:

[W]e need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.

Autism

Hillary Clinton has experience advocating for people on the autism spectrum and their families. As first lady, Clinton supported the Children’s Health Act of 2000, which expanded autism research. During her time in the senate, she co-sponsored legislation authorizing hundreds of millions of dollars in new spending on autism-related research, education and intervention programs. Should she be elected president, Clinton plans to:

• Expand insurance coverage for autism services.
• Help improve the time it takes to get an autism diagnosis, by conducting a nationwide early screening outreach campaign.
• Increase research funding, including research funding for how autism affects both children and adults.
• Increase employment opportunities for individuals with autism, as well as creating an initiative that provides student with autism a post-graduation transition plan.

Trump has no specific plans designed to help the millions of Americans on the spectrum and their families. Trump’s charitable foundation, however, donated $10,000 in 2010 to anti-vaxxer Jenny McCarthy’s organization, Generation Rescue.

Medical Marijuana, Opioids and Addiction

Trump’s plan to stop the rising rates of heroin use and addiction includes building a wall. During a campaign rally in New Hampshire, Trump stated, “We are going to build the wall, but we’re going to stop the poison from pouring in and destroying our youth and plenty of other people and we’re gonna work on those people that got addicted and are addicted and I’ll tell you what, we’re gonna do a real job for the state of New Hampshire.”

Neither Trump nor his campaign provided any additional details during the rally or after about his plan to help those already addicted to heroin. The campaign’s website does not mention addiction services or rehabilitation as part of its health care reform.

In 2015, at the Conservative Political Action Conference, Trump said he supports medical marijuana but not legalizing marijuana recreationally. “I’d say [regulating marijuana] is bad. Medical marijuana is another thing, but I think it’s bad and I feel strongly about that. If [states] vote for [legalizing marijuana], they vote for it… But I think, medical marijuana, 100 percent.”

Hillary Clinton also has a plan to treat drug abuse, focusing on prevention, treatment and recovery, providing first responders with naloxone (a drug that can prevent opioid overdoses from becoming fatal) and stricter standards and training programs for those who prescribe prescription pain medications. Clinton’s plan does not mention those who use opioids to manage chronic pain.

In August, the Clinton campaign released a statement saying Clinton, if elected, would make marijuana a Schedule II drug, symbolizing acceptance of marijuana’s medicinal properties. Clinton supports a state’s right to legalize marijuana both medicinally and recreationally, and has stressed making it easier to study the medicinal effects of marijuana.

Reproductive Rights

A woman’s right to choose became a protected federal right when the Supreme Court ruled on Roe v. Wade in 1973. Since then Republicans and Democrats have stood divided over whether or not abortions should be legal. As a Republican, Donald Trump is pro-life (against abortions). Trump was not always pro-life, switching from pro-choice to pro-life in 2011. Hillary Clinton is pro-choice, believing women’s personal health decisions should be made by a woman and her family, faith and doctor.

Before Roe v. Wade, individual states could pass their own laws prohibiting abortions. Today, abortions are a legal right nationwide, despite the fact that at least half of the states have passed laws that impose excessive regulations on abortion clinics. The only federal restriction on abortion is a ban on partial birth abortions, which were made illegal under the Partial-Birth Abortion Ban Act of 2003.

At the third presidential debate, moderator Chris Wallace asked Trump his stance on “late term partial birth abortions,” a term that does not exist since partial birth abortions are no longer performed in the U.S. and are different that late-term abortions. Trump replied, “Well I think it is terrible. If you go with what Hillary is saying, in the ninth month you can take baby and rip the baby out of the womb of the mother just prior to the birth of the baby. Now, you can say that that is OK and Hillary can say that that is OK, but it’s not OK with me. Because based on what she is saying and based on where she’s going and where she’s been, you can take baby and rip the baby out of the womb. In the ninth month. On the final day. And that’s not acceptable.”

An estimated 1.3 percent of abortions happen after 21 weeks of pregnancy, and the overwhelming majority of these abortions are because the mother’s life is at risk or the baby has a fatal birth defect. Late-term abortions are not covered by insurance and can cost anywhere between $10,000 to $25,000. They are not performed because a woman decides she no longer wants her child and they do not occur on the final day of pregnancy. They are almost always performed because of a medical emergency.

Clinton’s response at the third debate addressed the decisions women facing late-term abortion have to consider.

The kinds of cases that fall at the end of pregnancy are often the most heartbreaking, painful decisions for families to make. I have met with women who have, toward the end of their pregnancy, get the worst news one could get. That their health is in jeopardy if they continue to carry to term. Or that something terrible has happened or just been discovered about the pregnancy. I do not think the United States government should be stepping in and making those most personal of decisions. So you can regulate if you are doing so with the life and the health of the mother taken into account.

Trump hopes to overturn Roe v. Wade by appointing a conservative justice to the Supreme Court. The next president will have the unique position of confirming the ninth supreme court justice, and potentially two others. This ninth justice will have a large say in which way the court leans. A conservative justice could overturn Roe v. Wade and give the states back their right to regulate abortions. In addition to limiting access to abortions, Trump has commented that there should be “some form of punishment” for women who get abortions, a comment he has since retracted.

Trump also supports defunding Planned Parenthood, a nonprofit organization which provides affordable reproductive health care to both men and women. During the Republican primary debate in February, Trump praised Planned Parenthood, even though he said he would defund it. “[M]illions and millions of women – cervical cancer, breast cancer – are helped by Planned Parenthood. So you can say whatever you want, but they have millions of women going through Planned Parenthood that are helped greatly. And I wouldn’t fund it. I would defund it because of the abortion factor, which they say is 3 percent. I don’t know what percentage it is. They say it’s 3 percent. But I would defund it because I’m pro-life. But millions of women are helped by Planned Parenthood.”

Like all nonprofits, Planned Parenthood relies on grants and donations to be able to provide its services. The majority of the funds Planned Parenthood receives are from the U.S. government; however, none of these funds go towards abortion services. The majority of Planned Parenthood’s care is focussed around testing and treating sexually transmitted diseases and providing contraception. Abortion services count for 3 percent of the organization’s operation. Still, some republicans, Trump included, believe Planned Parenthood should receive zero government funding, because abortions are part of the services they offer.

Clinton is endorsed by Planned Parenthood, and has been vocal about her support of the organization and the work it does for women’s reproductive health care.

Healthcare Services for Veterans

Corruption scandals and inefficiencies at the Department of Veteran’s Affairs (VA), have left America’s veterans with inappropriate wait times for care and an overwhelming number of instances of subpar care. According to the VA, 20 veterans die by suicide, on average, each day. The risk of suicide for veterans is 21 percent higher than it is for the general population. In 2015 and 2016, there were numerous reports of inefficiencies at the VA’s crisis hotline with calls not being answered, returned or being transferred to under-trained professionals.

Donald Trump’s strongest healthcare policy comes in the form of his plan to reform veterans affairs. On his campaign’s website, Trump details a plan meant to address corruption, improve mental health outcomes and eliminate the wait times veterans face for healthcare. Trump’s 10-point plan includes:

• Appointing a VA secretary whose only job is advocating for veterans.
• Removing and disciplining federal employees who don’t act in the best interest of the country’s veterans.
• Asking Congress to pass legislation so that the VA Secretary can discipline or terminate employees who act against the best interests of veterans.
• Creating a commission that will investigate past and present issues at the VA.
• Protecting and promoting whistleblowing VA employees that highlight corruption or inefficiencies at the VA.
• Creating a 24-hour White House hotline devoted to screening calls from veterans about wrongdoing at the VA.
• Eliminating bonuses for wasteful VA employees and rewarding employees who seek to improve the service, save lives and cut waste.
• Reforming the visa system to ensure veterans receive health services first.
• Increasing the number of mental health care professionals for veterans.
• Allowing veterans to choose their care providers, either VA care or a private provider.

Despite his strong commitment to veterans, Trump was called out earlier this month for a comment he made regarding PTSD in veterans. “When people come back from war and combat and they see things that maybe a lot of the folks in this room have seen many times over,” Trump said while addressing a group of veterans. “You’re strong and you can handle it, but a lot of people can’t handle it.”

Hillary Clinton also has strong views when it comes to caring for America’s veterans. Her plan for improving services for veterans includes:

• Reforming veteran’s healthcare so that veterans receive timely, high-quality care, as well as improved care for female veterans. Clinton, unlike Trump, does not support privatization of care. Instead she wants to improve the care provided at the VA.
• Improving accountability and performance at the VA to eliminate the inefficiencies currently plaguing veterans seeking care
• Empowering veterans in the workplace and helping those who have completed their service find jobs or schooling, in addition to ending veteran homelessness.
• Overhauling the current VA hierarchy to create a new culture of accountability, service, and excellence at the VA.

Clinton’s plan also includes reforms meant to help the families of our servicemen and women, including helping military spouses and their children pursue jobs and education as well as providing more flexibility in military careers so that families can spend more times with their loved ones.

To see where the presidential candidates stand on more issues, check out On The Issues, a non-partisan website which complies statements made by both candidates on a number of issues.

Photo Credit: Gage Skidmore