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Campaign 2016: Health Care Policy Expert Examines Partisan Divide

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Presidential nominee Donald Trump took to social media Tuesday to express his liberation from the “shackles” of the Republican Party and resolve to “fight for America the way I want to.”

But during Sunday’s second presidential debate, he stuck closely to the Republican agenda on at least one issue — health care.

Candidates Debate Health Care

“If you strip the rhetoric out and strip out how anybody might feel about the candidates — and you just look at the substance — the candidates both delivered classic party line positions at Sunday’s debate,” said Shana Alex Charles, a Cal State Fullerton assistant professor of health science who has been studying health care policy issues since 1998. She continues to lead research on the impact of the divisive Patient and Protection Affordable Care Act, or “Obamacare.”

“Trump didn’t go off script and said the same things Republicans have been saying for the past five years, which is that we need to repeal the Affordable Care Act, get rid of state lines to increase competition among insurance companies and implement block grants for Medicaid,” she said.

Health care — an issue absent at the Sept. 26 presidential and Oct. 4 vice presidential debates — is the fourth most important issue to voters, according to a July poll by the Pew Research Center. Economy, terrorism and foreign policy were the top three issues.

“I would love to see health care talked about more, but that isn’t likely to happen until after the Nov. 8 election,” said Charles. “From my perspective, the Democrats are approaching the discussion in a more pragmatic and centrist way, which is to keep what’s working in the Affordable Care Act and to fix what’s not.”

What’s not working, according to both candidates, is the rising cost of health insurance premiums.

Trump’s proposal to eliminate state lines and implement block grants would reduce health care costs for the federal government and insurance companies, and likely increase the number of uninsured people and out-of-pocket expenses for consumers, said Charles.

Repealing the Affordable Care Act

“The main conversation the Republicans seem to want to have right now is to repeal the Affordable Care Act,” said Charles.

Since the enactment of the Affordable Care Act, an estimated 20 million Americans have gained access to health insurance.

During Sunday’s debate, presidential nominee Hillary Clinton underscored some fallouts from repealing the legislation, including: Insurance companies could once again deny coverage based on pre-existing conditions and implement lifetime limits; women would once again be charged more than men for health insurance; people under the age of 26 would no longer be covered by their parents’ policy unless they have student status.

“There would be a huge impact to repealing the Affordable Care Act, namely leaving a large portion of the population uninsured,” said Charles, adding, “Congress has voted to repeal the legislation over 50 times in the last decade, and it hasn’t happened yet.

“It just depends on what your goal is for the health insurance system: Do you want it to cover as many people as possible, or do you want to save the federal government money?”

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