Election Day 2020 promises to be one that shapes the lives of older Americans for years and possibly decades to come. If you’re over 50, you represent the largest block of voters by age group, one that has traditionally had a dramatic impact on presidential elections. With this influence, you have the power to shape the issues you care most about for your own and future generations. What Issues Concern You Most in This Presidential Election? There are a few key concerns that older adults want to address in this election, according to a recent AARP poll. The candidates’ plans for managing the COVID-19 crisis top the list this year, and you’ve likely seen an onslaught of media coverage intended to help you solidify your stance on this issue. What you may not have seen as often is coverage of other issues likely to affect you, namely Medicare and prescription drug prices. Let’s take a few minutes to see what each candidate has said about these pressing concerns that promise to profoundly impact your life and your loved ones’ lives. Where Trump and Biden Stand On Medicare President Trump has not yet offered an official plan for Medicare during this campaign. But the Trump administration’s 2021 budget proposal is perhaps the best indication of his future agenda. In this budget proposal, the administration says it will: Protect and improve the Medicare program Address improper payments in Medicare and Medicaid The proposal offers few details about how the administration plans to protect and improve Medicare, only that it will. Recently, though, the administration announced changes to Medicare that allow Medicare Advantage plan members greater access to telehealth and expands Medicare Advantage benefits for those with chronic illnesses and those who live in rural areas. The proposed budget for next year states as a priority the standardizing of payments for medical care regardless of the site where care is received, and increased access to telehealth, both of which would be wins for seniors. Trump’s budget includes greater restrictions on Medicaid eligibility, including work requirements, so one might conclude that overall healthcare savings could come from having fewer people eligible for Medicaid coverage. According to the Kaiser Family Foundation, however, nearly one in five Medicare recipients is also covered by Medicaid, which serves as a supplement to Medicare coverage for low-income beneficiaries. If drastic cuts are made to Medicaid, this could have a negative effect on low-income senior citizens and on Medicare spending. The cornerstone of Trump’s healthcare initiative is to dismantle the Affordable Care Act (ACA), which could account for his overall savings estimates. According to experts, this would likely also leave millions of people uninsured. If the ACA were to be repealed as Trump has proposed, Medicare recipients would lose benefits the ACA provided: incremental closing of the Medicare prescription drug “donut hole” and free coverage of preventive services. In 2017, President Trump enacted the Tax Cut and Jobs Act of 2017 and repealed the ACA provision known as “the Cadillac tax,” a move that has accelerated the insolvency of the Medicare Trust Fund. The president has consistently backed deep cuts to federal programs, and his budget proposal reaffirms this priority. Medicaid and Medicare spending over the next decade would be dramatically reduced: $900 billion in cuts for Medicaid and $450 billion for Medicare. With no other explanations given, it might be inferred that these savings would be due to cuts in coverage. Biden’s Plan Is Dramatically Different Biden has outlined a plan for Medicare that diverges significantly from his opponent's. Biden plans to: Lower the Medicare eligibility age to 60 Offer a Medicare-like public option for health insurance Add vision, hearing, and dental benefits to Medicare Biden’s proposal to lower the age of Medicare eligibility from 65 to 60 means that 20 million more Americans would be eligible for Medicare benefits, according to the Biden campaign. The Medicare-like public option would be an alternative for working-age adults who do not have or cannot afford employer-based benefits. Just as Medicare is able to negotiate lower rates for medical care than private insurance, this Medicare-like public insurance should be able to negotiate lower rates than private entities, offering an affordable solution for many people. Biden has pledged to protect and build on the Affordable Care Act. His campaign has estimated that his plan will insure 97 percent of Americans and cost roughly $750 billion over the next decade. It would be paid for by an increase in capital-gains taxes. Although many members of his party have voiced support for “Medicare for all,” Biden’s plan does not go so far as to embrace Medicare for all. His plan is a more centrist approach to enact incremental change to the current infrastructure of Medicare rather than a complete overhaul. Where Biden and Trump Stand on Prescription Drug Prices Perhaps one of the few issues where the two candidates find common ground is the need to control prescription drug prices, and the American public agrees. According to a recent poll, more than 81 percent of voters over 50 say that a candidate who ignores the rising cost of prescription drugs risks losing their vote. The AARP, the nation’s largest nonprofit, nonpartisan advocacy group for adults over 50, has launched a nationwide campaign advocating lower prescription drug prices for all Americans. In order to effect real change on prescription drug prices, AARP supports five key policy changes: Allow Medicare to negotiate prescription drug prices. Allow states to negotiate lower drug prices. Give state attorneys general power to reign in exorbitant price increases Close loopholes that allow companies to delay the arrival of generic alternatives on market. Cap consumers’ out-of-pocket prescription cost. With that assessment in mind, take a look at what each candidate proposes. Biden’s Plan for Addressing Rising Medication Costs Biden's plan will: Repeal the exception that allows drug companies to avoid negotiating drug prices with Medicare. Establish an independent review board to set a reasonable price for new drugs. Limit drug price increases to the current inflation rate. Allow consumers to buy medications from other countries. End pharmaceutical companies’ tax breaks for advertising. Accelerate development and increase availability of generic medications. What Trump Has Done to Lower Drug Prices Throughout his first term, Trump has reiterated his 2016 campaign pledge to lower prescription drug costs. During the 2016 campaign, Trump also voiced support for repealing the law that prevents Medicare from negotiating drug prices with pharmaceutical companies. Since taking office, however, he has not furthered this agenda. What he has done, is: Made it easier to import drugs from other countries Limited rebates pharmacy benefit managers can get when they negotiate prices with drug companies for Medicare Part D plans Capped monthly insulin costs for some members enrolled in Part D plans Increased the number of generics available His 2021 budget proposal says the administration will: Support bipartisan initiatives to control drug prices by increasing drug company rebates to the federal government Improve Medicare Part D by supporting out-of-pocket maximums for seniors and offering incentives that will lower costs and out-of-pocket spending The Takeaway Trump and Biden as presidential candidates have acknowledged the complexities and challenges of two issues that matter greatly to America’s older generation: Medicare and prescription drug prices. Trump seems likely to continue on his current path of dismantling the Affordable Care Act where possible, reducing costs (and likely coverage) of Medicaid, providing support for Medicare and, more specifically, Medicare Advantage plans, and curbing prescription drug prices. Biden’s plan proposes lowering the age of eligibility for Medicare from 65 to 60 and offers a Medicare-like public insurance option. His proposal would expand insurance coverage to millions of Americans and would be financed by changes in capital-gains tax law. Biden supports an aggressive approach to lowering prescription drug prices by allowing Medicare to negotiate drug prices with the drug companies and regulating the prices drug companies are allowed to set. As the needs for Americans grow because of current events that have upended the lives of many — the COVID-19 pandemic, job loss, and the economic downturn — it will become urgent for our next president to address these issues of vital importance to the health and well-being of older Americans. Source
