Steve November 24, 2021

The main differences between Trump, Biden, and Bernie on healthcare centers around how insurance is paid for and what benefits are included. That then impacts who gets insurance, what it costs, and what taxes look like.

All three on paper say they want to expand coverage, go after drug companies, and reduce costs.

Trump has done this in practice by getting rid of parts of the ACA and freeing up what types of insurance can be sold (generally meaning benefits are traded for lower costs; for example on short term plans). This is paired with tax cuts. This is paid for via a mix of public spending and consumer costs. Trump’s changes didn’t do much to reduce costs, but there were tax cuts. Further, the party is generally against expanding Medicaid or increasing the size of tax credits.

Biden wants to expand Medicaid and the current insurance market. One way his plan does this is through creating a public option. On his plan more people would be covered, due to the option offering coverage to those struggling. This plan offers more benefits on more plans than Trump’s plan. This is paid for via a mix of public spending and consumer costs, consumer costs are lower on paper than Trump’s plan, but public spending is higher (although this is offset by the tax reform aspect to a degree).

Bernie wants to expand Medicare to all. This would replace the existing market. Everyone would be covered under this plan by default (unlike the other plans). This is the most robust plan in terms of benefits and coverage. This plan also costs the most. This plan is mostly funded by taxes, and as such logically the plan would include new taxes, not just on the wealthy.

When you consider premiums, deductibles, and who pays what taxes, one could argue Bernie’s plan provides the most value to the most people. However, when you consider disruption to the current system, Trump’s plan wins hands down. Meanwhile, Biden’s middle ground plan comes somewhere in-between.

All plans use a mix of public and private spending, all plans use private healthcare delivery, and all plans generally offer coverage to everyone. However, Trump’s plan leaves tens of millions without coverage, Biden’s leaves far less without coverage in theory but still retains things like restrictive out-of-pocket costs that cause consumers to ration healthcare, while Bernie’s plan solves these issues… but at a cost to the taxpayer.

Each plan has its pros and cons, but that is the gist.

For more see: Bernie Sanders: Medicare-for-all, Biden’s “Protect and Build ObamaCare” plan, and “TrumpCare explained.”

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