Vice President Kamala Harris is mocking former President Donald Trump for saying he has “concepts of a plan” to replace Obamacare.
She’d do well to remove the plank from her own eye before slamming her opponent for a gaffe. During his presidency, Trump advanced several reforms that expanded access to affordable coverage.
Harris, by contrast, has been mum on whether she continues to support a government takeover of the health insurance system as she did during her first run for the presidency. Instead, she has said that she wants to strengthen the Affordable Care Act and extend President Joe Biden’s ruinously expensive scheme of enhanced premium subsidies permanently.
Pushing more patients onto the exchanges won’t make coverage more affordable.
Start with the price of insurance. According to the Paragon Health Institute, premiums in the individual market have risen 50% faster than employer plan premiums over the last 10 years. Average deductibles for mid-level silver plans have more than doubled between 2014 and 2024.
Because premiums are on the rise, customers are increasingly opting for less generous bronze plans that require lower monthly outlays. A decade ago, only 1 in 3 exchange enrollees had a bronze plan. More than half do now.
Lower premiums mean higher deductibles. According to KFF, bronze plans come with an average deductible of $7,258.
Now look at the employer market, where the average deductible is just $1,735. A whopping 84% of people with employer-sponsored insurance have deductibles under $3,000, based on Paragon’s research.
Despite high premiums and deductibles, Obamacare comes with scant benefits. Over the last decade, the share of exchange enrollees in plans with broad provider networks plunged from 36% to just 11%, according to Paragon’s research.
In other words, people may find themselves paying hundreds of dollars every month for insurance the doctor they’d like to see doesn’t accept.
Harris wants to keep subsidizing this failing insurance ecosystem. Her plan for healthcare would push more patients into poor-quality plans at taxpayer expense.
Trump has a different idea. His running mate, Sen. J.D. Vance (R-OH), says the former president would deregulate the insurance market to “not have a one-size-fits-all approach that puts a lot of people into the same insurance pools.”
During his first term, Trump allowed people to purchase short-term health plans that lasted for up to 364 days and could be renewed for up to three years. These plans cost less than exchange coverage because they don’t have to comply with Obamacare’s many regulations, including the requirement that plans cover 10 essential health benefits regardless of whether people want or need them. In many cases, short-term plans can offer better coverage than what’s available on the exchanges for less money, according to research from the Manhattan Institute.
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The Biden-Harris administration reversed the Trump-era liberalization of the short-term insurance market by capping the plans’ duration at three months, with an option for a one-month renewal. Some states, including California, New York, and New Jersey, have totally banned them on the grounds that they’re “junk” insurance.
Both candidates have a plan for healthcare. Harris’s plan will make coverage less affordable — Trump’s could make it more so.
Sally C. Pipes is the president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X: @sallypipes.