Neither presidential candidate has put forth a plan to address the growing national debt, nor do the candidates have proposals to address healthcare cost growth, according to the Committee for a Responsible Federal Budget.
The nation's current public debt totals $14 trillion and is growing — it accounts for 75 percent of GDP now, but is expected to grow to 86 percent by 2026. Four-fifths of that growth can be chalked up to Social Security, federal health spending and interest, according to CRFB. Combined, Medicare, Medicaid and insurance subsidies are the largest and fastest growing part federal spending category, according to CRFB.
CRFB issued a fiscal guide to both Hillary Clinton's and Donald Trump's policies, including a financial breakdown of each candidates' healthcare proposal.
"Although both Secretary Clinton and Mr. Trump would enact significant changes to the healthcare system, those changes would take very different forms — and neither would fundamentally change the underlying trajectory of healthcare cost growth," the authors of the report wrote.
Here are six key fiscal comparisons of the candidates' healthcare plans from the CRFB analysis.
1. The net cost of Ms. Clinton's healthcare proposals would be $150 billion over the next 10 years, while Mr. Trump's healthcare proposals would cost a net $50 billion over the same time period. However, depending on how things shake out, CRFB provides a high-cost estimate of Ms. Clinton's policies of $300 billion. CRFB's high and low cost estimates of Mr. Trump's healthcare policies are much wider: they could save more than $850 billion or cost more than $550 billion.
2. Mr. Trump's changes to the Affordable Care Act would cost $200 billion more over the next decade than Ms. Clinton's changes, when not incorporating economic feedback. CRFB estimates Ms. Clinton's proposed changes to the ACA would cost $300 billion. These changes include providing more federal support to states to expand Medicaid, increasing outreach to those who are not enrolled but eligible for Medicaid or subsidies, limiting out-of-pocket premium costs, increasing subsidies and creating a new refundable tax credit to some to cover out-of-pocket health costs. Mr. Trump's proposed changes to the ACA — which include repealing the entire law — would cost an estimated $500 billion. While insurance spending would decrease dramatically, repealing the ACA would eliminate Medicare savings and revenue increases. However, repealing the ACA would also spur economic growth, and if the effects of economic feedback are included it could reduce the net cost of this plan by 50 percent.
3. The candidates' changes to taxes on health insurance would both cost $100 billion over 10 years. For Ms. Clinton, this includes repealing the so-called "Cadillac tax" on luxury health plans. For Mr. Trump, this includes allowing individual health plans to be tax deductible and expanding health savings accounts.
4. Ms. Clinton's proposed drug cost reductions and "public option" reforms would net positive, at $200 billion over then next 10 years, while Mr. Trump's proposed drug cost reductions and interstate sale of health insurance would net positive $50 billion. Both candidates want to lower barriers to drug importation. Mr. Trump has called for Medicare to negotiate drug prices directly with pharmaceutical companies, while Ms. Clinton has called for minimum rebates to be a requirement for drug manufacturers to participate in Medicare, among other details. She has also called for states to provide a public health insurance option, while Mr. Trump has called for the sale of health insurance across state lines.
5. Ms. Clinton's proposal to prohibit pharmaceutical companies from deducting advertising costs from their taxes would generate $50 billion over the next decade. This policy is an effort to cut down on direct-to-consumer advertising. Mr. Trump does not have a parallel proposal.
6. Mr. Trump's Medicaid block grant proposal could reduce debt by as much as $1.05 trillion or as little as $0, though the CRFB estimates it will reduce debt by $500 billion over the next 10 years. This policy would allow states to independently determine how Medicaid funds should be spent. The range of estimates reflects that the policy could save or cost almost anything depending on the size and growth rate of the block grants, and how states choose to design them.
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