On 8 November 2016, Americans will go to the polls to elect Democrat Hillary Clinton or Republican Donald Trump the next president of the United States. In the key area of human resources policy, the views of Democrats and Republicans are a striking study in contrasts.

Affordable Care Act

Six years after enactment the public remains divided on the ACA, with about half of those surveyed having an unfavourable view of the law. In their competing plans Democrats and Republicans reflect that divide.

Democrats. The Democratic platform embraces the ACA, calling it “a critically important step toward the goal of universal health care”, and are “proud to be the party that passed the Affordable Care Act”. The party would double-down on the law or, as Mrs Clinton puts it, “build on the ACA”.

Specifically, the platform calls for three big changes. First, adding a ‘Public Option’ to the federal and state health insurance exchanges, i.e., giving the 10 million or so enrollees the option of selecting a Medicare or Medicaid-like health plan instead of a private insurance plan. Second, “keeping costs down by making premiums more affordable, reducing out-of-pocket expenses and capping prescription drug costs”, presumably by expanding the present government-financed premium tax credits or cost-sharing reduction subsidies. Finally, repealing the ACA’s 40 percent excise tax on high-cost health insurance, known as the ‘Cadillac Tax’, slated to go into effect in 2020. The platform is silent on what might replace this $90bn, 10-year funding source for premium and cost-sharing subsidies.

Oct-Dec 2016 Issue