With tonight culminating in the 2016 election's final debate between Democratic nominee Hillary Clinton and Republican nominee Donald Trump, take a look at where they stand on a range of employee benfeit policies from paid leave to the fate of the ACA's excise tax.
The Affordable Care Act
Clinton: Supportive of the Affordable Care Act, Hillary Clinton wants to build on the healthcare law’s successes, while making some tweaks — such as a repeal of the Cadillac tax and increased access to pharmaceutical benefits.
Trump: Seeks a repeal of the ACA, but wants to keep some parts of it, including the pre-existing condition exclusion provisions.
Trump and Clinton both seek to repeal the excise tax of 40% on the cost of health coverage exceeding the threshold value of $10,200 for individual coverage and $27,500 for a family. Set to begin in 2020 and is considered a major funding vehicle for the healthcare law.
Of the 35 countries in the Organization for Economic Co-operation and Development — a group for highly developed economies — the United States is the only nation that doesn’t mandate paid maternity leave. It does, however, mandate that companies provide a minimum of 12 weeks of unpaid leave to expecting mothers.
Trump: Promises “six weeks of paid maternity leave to any mother with a newborn child whose employer does not provide the benefit.” His plan outlined on his website does not mention if the policy applies to same-sex parents. He says his maternity leave policy will be completely paid for through the unemployment insurance program.
Clinton: Promises 12 weeks of paid family leave to care for biological and adopted children. Her policy applies to parents of either or both genders. According to her website, her parental leave policy will be paid by “tax reforms that will ensure the wealthiest Americans pay their fair share.” Parents on parental leave can expect at least 67% of their current wages, up to an as-yet-unspecified ceiling, Clinton says.
Cost of health coverage
Although both candidates agree the cost of healthcare coverage needs to go down, both come at it though some slightly different methods.
Trump proposes to increase consumer choice, provide individual tax relief for health insurance and keep plans portable and affordable. He also seeks to break health insurance company monopolies and allow individuals to buy insurance across state lines.
Clinton has also argued against health insurance monopolies and has published a comprehensive plan for reducing out-of-pocket health insurance costs.
Childcare should not exceed more than 10% of a family’s budget, yet families below the poverty line spend nearly 30% of their income on childcare, according to the U.S. Census Bureau.
Clinton’s policy aims to cap childcare at 10%, relying on tax cuts or state block grants to subsidize costs exceeding that mark.
Trump’s childcare policy allows families with a stay-at-home parent to deduct the average cost of childcare from their taxes through an Earned Income Tax Credit. “For low-income individuals who have no net income tax liability, we will offer an expanded earned income tax credit, that’s EITC, in the form of a childcare rebate,” he says. “Working parents can get an expanded EITC benefit that equals up to half of their total payroll tax, a major relief for low-income parents.”
Dependent care savings accounts
Trump’s plan allows parents to contribute up to $2,000 to a tax-free dependent care savings account. Parents do not have to depend on their employer to set up an account for each of their children, and funds will remain in the account until the age of 18. “Whatever still remains at that time can be used to help offset the cost of higher education for your child,” says Trump.
Clinton does not include a dependent care savings account in her policy.
Clinton’s plan proposes free public pre-kindergarten as a direct government investment to cut down on childcare costs.
Trump’s childcare plan includes a tax credit for employers to provide childcare at the workplace and contribute to an employees’ cost of childcare.
Prescription drug costs
Another topic of common ground, both Clinton and Trump agree the cost of prescriptions drugs needs to drop. Both support allowing government-run Medicare to set drug prices to reduce the growth in healthcare costs.
With recent announcements of big proposed mergers between insurer groups (Humana and Aetna, Anthem and Cigna, etc.), both Trump and Clinton have expressed concern this will lead to fewer options for consumers.
The common answer between Trump and Clinton is yes to more healthcare provider transparency. Clinton does take her comments one step further, specifically mentioning the need to end “surprise” medical bills that occur.
While Clinton has not expressed any expansion on the initiative, Trump supports consumer-driven health plans. And his proposed healthcare plan calls for tax-free HSAs and greater access and portability of CDHPs.
Purchasing insurance across state lines
Currently, states set their own regulations for insurance and establish their own requirement, inhibiting interstate sales of health insurance. This has been a major policy initiative for Trump, and he proposes to modify these laws in an effort to increase competition. Clinton has not addressed this topic on the campaign trail so far.
Clinton: Prefers the ACA model over a single-payer model.
Trump: While he says he would repeal the ACA, he has made comments suggesting he would be open to some kind of free healthcare option or single-payer system.