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Clinton Seeks To Build On Health Law, But Does She Have The Rx For Rising Health Costs?

Democratic presidential candidate Hillary Clinton speaks on stage during the New Hampshire Democratic Party Convention in Manchester, N.H. on Sept. 1, 2015. (Photo by Scott Eisen/Getty Images)

While the Republicans running for president are united in their desire to repeal the federal health law, Democrat Hillary Rodham Clinton is fashioning her own health care agenda to tackle out-of-pocket costs 鈥 but industry experts question whether her proposals would solve the problem.

In addition to defending , Clinton released two separate proposals this week. One would seek to protect people with insurance from having to pay thousands of dollars in addition to their premiums for ; the other would set for those with insurance.

鈥淲hen Americans get sick, high costs shouldn鈥檛 prevent them from getting better,鈥 said Clinton in a statement provided by the campaign. 鈥淢y plan would take a number of steps to ease the burden of medical expenses and protect health care consumers.鈥

The drug plan would, among other things, cap payments for covered prescriptions at $250 per month and let the government negotiate prices for the Medicare program. The overall health spending plan would let people see a doctor at least three times a year without having to first satisfy their deductible and create a new tax credit for those whose out-of-pocket spending is more than聽 5 percent of their annual income.

But while surveys show that health costs, and , are a top concern for many voters, it鈥檚 not at all clear that Clinton鈥檚 proposals 鈥 have been 鈥 would provide an actual cure.

鈥淭here鈥檚 no magic bullet here except getting health costs down,鈥 said Len Nichols, a health economist at George Mason University and a longtime backer of the federal health law.

The fundamental problem, says Nichols, was built into the health law itself. By requiring many new benefits, such as maternity care and coverage for mental health and substance abuse,聽 insurers were left with few choices when trying to keep premiums from spiraling. Many insurers narrowed their provider networks and collected more from customers who use the system most.

鈥淭he degree to which these out-of-pocket realities hit those with chronic conditions harder, it means we鈥檙e not accomplishing the social objective of sharing the risk,鈥 said Nichols.

But setting specific limits for those who are sick will simply drive up premiums for everyone, says the insurance industry. 鈥淲hen you look at mandating additional benefits, that has a huge impact on the cost of coverage,鈥 said Clare Krusing, a spokeswoman for America鈥檚 Health Insurance Plans (AHIP), the industry trade group.

And even if that was a tradeoff the public 鈥 and policymakers 鈥 decide they are willing to make, there is a phalanx of lobbyists in Washington bent on making sure many of these changes never happen.

For example, , head of the Pharmaceutical Research and Manufacturers of America, said Clinton鈥檚 drug proposal 鈥渨ould restrict patients鈥 access to medicines, result in fewer new treatments for patients, cost countless jobs across the country and could end our nation鈥檚 standing as the world leader in biomedical innovation.鈥

Meanwhile, Clinton鈥檚 proposed limit on advertising to consumers for prescription drugs has drawn the ire of the advertising industry. The Association of National Advertisers called the proposal 鈥渨rong and misguided.鈥

Even the insurance industry, which has been relentlessly campaigning against high drug prices, has come out against Clinton鈥檚 plan. Marilyn Tavenner, AHIP president and CEO, said that 鈥減roposals that would impose arbitrary caps on insurance coverage or force government negotiation on prescription drug prices will only add to the cost pressures facing individuals and families across the country.鈥

Still, the advent of both blockbuster new drugs that cost , plus sudden spikes in prices of , may prove to be a tipping point.

More than a half dozen states have already imposed some sort of , either through law or regulation.

Republicans, meanwhile, have yet to settle on how they would replace the Affordable Care Act, concedes Chris Jacobs, a senior editor for the Conservative Review.

鈥淩epublicans need to have a better and more substantive alternative than health savings accounts, liability reform, and cross-state purchasing,鈥 he said, referring to ways people can save tax-free for their own health bills, medical malpractice reform and allowing individuals to purchase insurance from states other than their own. All are Republican ideas dating back several campaigns.

But when it comes to cost, Republicans have a major case against the authors of the health law, Jacobs says.

鈥淭hey were never honest with the American people about how much this was really going to cost and the tradeoffs needed to pass it,鈥 he said. He likened President聽 Barack Obama, when he was lobbying for the bill, to Oprah Winfrey on her television show鈥檚 famous give-away episode聽 鈥 鈥淵OU get a car, and YOU get a car,鈥 he said. Basically the backers were offering everything to everyone at the same time many of the costs were either hidden or pushed off to the future, he said.

Nichols agrees, at least to a point. 鈥淭he (health) law did answer all questions, but now we鈥檙e ready to revisit because we didn鈥檛 like all the answers.鈥

Related Topics

Cost and Quality Elections Health Industry Pharmaceuticals The Health Law