Clinton and Trump to inherit intractable health care issue
Clinton would try to fix Obamacare, Trump wants to repeal and replace
(CNN) —
President Barack Obama leaves the White House in 12 weeks, but the law that bears his name will polarize politics long after he’s gone.
Big price hikes to Affordable Care Act premiums announced this week mean that Obama’s proudest legislative achievement will fail to resolve the decades-old controversy surrounding the government’s role in managing the cost of and access to health care.
It will fall to the next administration whether to fix Obamacare’s shortcomings – including rising premiums and deductibles, slowing enrollment growth and the increasing number of insurers pulling out of the ACA marketplaces – or to trash the system and start again. Neither Hillary Clinton nor Donald Trump have laid out a detailed plan for how they would revise or replace the law or how they would navigate the toxic politics that surface in Washington whenever health care is on the agenda.
Trump has proven better at condemning Obamacare – his stump speech includes vows to repeal and replace it – than saying how he would tackle the crisis over access and cost. He hasn’t made health reform a centerpiece of his campaign.
“My first day in office, I’m going to ask Congress to put a bill on my desk getting rid of this disastrous law and replacing it with reforms that expand choice, freedom and affordability,” Trump said Tuesday in Florida. “Hillary Clinton wants to double down on Obamacare and make it even worse. She wants to put the government totally in charge of your health care.”
Still, Clinton has been far more up front about what she would try to accomplish.
“The President and I have talked about it,” Clinton told WHCQ Radio in Florida on Tuesday. “We’re going to get copays and premiums and deductibles down. We’re going to tackle prescription drug costs. And we can do that without ripping away the insurance that people now have.”
Clinton’s campaign said she would increase competition among insurers to improve choices for Obamacare customers, including a public option, and would take on pharmaceutical companies over rising drug prices and provide tax relief for out of pocket expenses. Her plan also includes incentives for states to expand Medicaid. Plans previously published by her campaign include pledges to tackle diseases like Alzheimer’s and autism, substance abuse and Zika and aims to improve public and rural health infrastructure.
Political minefield
The former first lady and New York senator has been working in the political minefield of health care for decades – dating back to her failed effort during her husband’s administration in the 1990s.
President-elect Donald Trump has been in the spotlight for years. From developing real estate and producing and starring in TV shows, he became a celebrity long before winning the White House.
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Trump at age 4. He was born in 1946 to Fred and Mary Trump in New York City. His father was a real estate developer.
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Trump, left, in a family photo. He was the second-youngest of five children.
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Trump, center, stands at attention during his senior year at the New York Military Academy in 1964.
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Trump, center, wears a baseball uniform at the New York Military Academy in 1964. After he graduated from the boarding school, he went to college. He started at Fordham University before transferring and later graduating from the Wharton School, the University of Pennsylvania's business school.
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Trump stands with Alfred Eisenpreis, New York's economic development administrator, in 1976 while they look at a sketch of a new 1,400-room renovation project of the Commodore Hotel. After graduating college in 1968, Trump worked with his father on developments in Queens and Brooklyn before purchasing or building multiple properties in New York and Atlantic City, New Jersey. Those properties included Trump Tower in New York and Trump Plaza and multiple casinos in Atlantic City.
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Trump attends an event to mark the start of construction of the New York Convention Center in 1979.
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Trump wears a hard hat at the Trump Tower construction site in New York in 1980.
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Trump was married to Ivana Zelnicek Trump from 1977 to 1990, when they divorced. They had three children together: Donald Jr., Ivanka and Eric.
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The Trump family, circa 1986.
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Trump uses his personal helicopter to get around New York in 1987.
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Trump stands in the atrium of the Trump Tower.
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Trump attends the opening of his new Atlantic City casino, the Taj Mahal, in 1989.
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Trump signs his second book, "Trump: Surviving at the Top," in 1990. Trump has published at least 16 other books, including "The Art of the Deal" and "The America We Deserve."
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Trump and singer Michael Jackson pose for a photo before traveling to visit Ryan White, a young child with AIDS, in 1990.
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Trump dips his second wife, Marla Maples, after the couple married in a private ceremony in New York in December 1993. The couple divorced in 1999 and had one daughter together, Tiffany.
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Trump putts a golf ball in his New York office in 1998.
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An advertisement for the television show "The Apprentice" hangs at Trump Tower in 2004. The show launched in January of that year. In January 2008, the show returned as "Celebrity Apprentice."
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A 12-inch talking Trump doll is on display at a toy store in New York in September 2004.
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Trump attends a news conference in 2005 that announced the establishment of Trump University. From 2005 until it closed in 2010, Trump University had about 10,000 people sign up for a program that promised success in real estate. Three separate lawsuits -- two class-action suits filed in California and one filed by New York's attorney general -- argued that the program was mired in fraud and deception. Trump's camp rejected the suits' claims as "baseless." And Trump has charged that the New York case against him is politically motivated.
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Trump attends the U.S. Open tennis tournament with his third wife, Melania Knauss-Trump, and their son, Barron, in 2006. Trump and Knauss married in 2005.
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Trump wrestles with "Stone Cold" Steve Austin at WrestleMania in 2007. Trump has close ties with the WWE and its CEO, Vince McMahon.
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For "The Apprentice," Trump was honored with a star on the Hollywood Walk of Fame in January 2007.
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Trump appears on the set of "The Celebrity Apprentice" with two of his children -- Donald Jr. and Ivanka -- in 2009.
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Trump poses with Miss Universe contestants in 2011. Trump had been executive producer of the Miss Universe, Miss USA and Miss Teen USA pageants since 1996.
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In 2012, Trump announces his endorsement of Republican presidential candidate Mitt Romney.
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Trump speaks in Sarasota, Florida, after accepting the Statesman of the Year Award at the Sarasota GOP dinner in August 2012. It was shortly before the Republican National Convention in nearby Tampa.
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Trump appears on stage with singer Nick Jonas and television personality Giuliana Rancic during the 2013 Miss USA pageant.
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In June 2015, during a speech from Trump Tower, Trump announced that he was running for President. He said he would give up "The Apprentice" to run.
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Trump -- flanked by U.S. Sens. Marco Rubio, left, and Ted Cruz -- speaks during a CNN debate in Miami on March 10. Trump dominated the GOP primaries and emerged as the presumptive nominee in May.
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The Trump family poses for a photo in New York in April.
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Trump speaks during a campaign event in Evansville, Indiana, on April 28. After Trump won the Indiana primary, his last two competitors dropped out of the GOP race.
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Trump delivers a speech at the Republican National Convention in July, accepting the party's nomination for President. "I have had a truly great life in business," he said. "But now, my sole and exclusive mission is to go to work for our country -- to go to work for you. It's time to deliver a victory for the American people."
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Trump faces Democratic nominee Hillary Clinton in the first presidential debate, which took place in Hempstead, New York, in September.
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Trump apologizes in a video, posted to his Twitter account in October, for vulgar and sexually aggressive remarks he made a decade ago regarding women. "I said it, I was wrong and I apologize," Trump said, referring to lewd comments he made during a previously unaired taping of "Access Hollywood." Multiple Republican leaders rescinded their endorsements of Trump after the footage was released.
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Trump walks on stage with his family after he was declared the election winner on November 9. "Ours was not a campaign, but rather, an incredible and great movement," he told his supporters in New York.
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Trump is joined by his family as he is sworn in as President on January 20.
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But her broad knowledge of possible approaches will not help her solve the fundamental political problem surrounding Obamacare: any legislative fix to the law will require some level of support from Congress. And unless she is able to whip up a Democratic wave sufficient to claim back the GOP-dominated House, the political fight over rescuing Obamacare will be fierce.
Republicans in the House who have voted over 50 times to repeal the law aren’t likely to line up to save it. And even some Democratic senators from red states up for re-election in a brutal 2018 mid-term election slate may shy away from tough votes to prolong the law.
Trump does have a position paper on the issue, in which he promises to repeal the individual mandate, modify laws that prohibit the sale of health insurance across state lines and allow people to deduct insurance premiums from their tax returns.
Trump would promote individual Health Savings Accounts with tax free contributions and would allow patients access to imported drugs from overseas to bring down prices.
But he offers few insights into how he would take on and defeat the huge vested health care interests that are a powerful influence on Washington politics or how he would overcome resistance to some aspects of his plans from his own party.
Rep. Chris Collins, a New York Republican, told CNN’s Wolf Blitzer Tuesday that he believes Trump would adopt the health care plan drawn up by House Speaker Paul Ryan’s Republican conference.
“It is my understanding that Mr. Trump has seen that plan and what he is talking about … is in fact a better way, a replacement plan,” Collins said.
2016 fallout
The Obamacare price hikes – the government said Monday premiums for the benchmark plan are set to rise an average of 22% next year – are a surprise twist in the final stretch of a campaign that had seemed to settle down in recent days. Trump was quick to seize on the issue, suggesting he believes it’s something he can use to throw Clinton, who is leading most polls, on the defense.
“It’s blowing up all over the country,” Trump told reporters Tuesday at his golf resort in Doral, Florida, vowing to repeal and replace Obamacare with something less expensive.
The rising premiums could also provide a boost for Republican Senate candidates who are struggling to overcome opposition to Trump in their states. The National Republican Senatorial Committee released a video of Katie McGinty, a Pennsylvania Democrat who is locked in a tight race with incumbent Republican Pat Toomey, in which she said Democrats should be “proud of” Obamacare.
“Is Shady Katie still proud of Obamacare?” the NRSC released asked.
Iowa Republican Party chairman Jeff Kaufmann said in a statement that Democrat Patty Judge, who is seeking to unseat GOP Sen. Chuck Grassley, “cheers and hollers for the Obamacare disaster.”
Photos: Hillary Clinton's life in the spotlight
Hillary Clinton accepts the Democratic Party's nomination for president at the Democratic National Convention in Philadelphia on July 28, 2016. The former first lady, U.S. senator and secretary of state was the first woman to lead the presidential ticket of a major political party.
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Before marrying Bill Clinton, she was Hillary Rodham. Here she attends Wellesley College in Massachusetts. Her commencement speech at Wellesley's graduation ceremony in 1969 attracted national attention. After graduating, she attended Yale Law School.
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Rodham was a lawyer on the House Judiciary Committee, whose work led to impeachment charges against President Richard Nixon in 1974.
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In 1975, Rodham married Bill Clinton, whom she met at Yale Law School. He became the governor of Arkansas in 1978. In 1980, the couple had a daughter, Chelsea.
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Arkansas' first lady, now using the name Hillary Rodham Clinton, wears her inaugural ball gown in 1985.
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The Clintons celebrate Bill's inauguration in Little Rock, Arkansas, in 1991. He was governor from 1983 to 1992, when he was elected President.
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Bill Clinton comforts his wife on the set of "60 Minutes" after a stage light broke loose from the ceiling and knocked her down in January 1992.
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In June 1992, Clinton uses a sewing machine designed to eliminate back and wrist strain. She had just given a speech at a convention of the International Ladies' Garment Workers Union.
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During the 1992 presidential campaign, Clinton jokes with her husband's running mate, Al Gore, and Gore's wife, Tipper, aboard a campaign bus.
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Clinton accompanies her husband as he takes the oath of office in January 1993.
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The Clintons share a laugh on Capitol Hill in 1993.
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Clinton unveils the renovated Blue Room of the White House in 1995.
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Clinton waves to the media in January 1996 as she arrives for an appearance before a grand jury in Washington. The first lady was subpoenaed to testify as a witness in the investigation of the Whitewater land deal in Arkansas. The Clintons' business investment was investigated, but ultimately they were cleared of any wrongdoing.
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The Clintons hug as Bill is sworn in for a second term as President.
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The first lady holds up a Grammy Award, which she won for her audiobook "It Takes a Village" in 1997.
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The Clintons dance on a beach in the U.S. Virgin Islands in January 1998. Later that month, Bill Clinton was accused of having a sexual relationship with former White House intern Monica Lewinsky.
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Clinton looks on as her husband discusses the Monica Lewinsky scandal in the Roosevelt Room of the White House on January 26, 1998. Clinton declared, "I did not have sexual relations with that woman." In August of that year, Clinton testified before a grand jury and admitted to having "inappropriate intimate contact" with Lewinsky, but he said it did not constitute sexual relations because they had not had intercourse. He was impeached in December on charges of perjury and obstruction of justice.
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The first family walks with their dog, Buddy, as they leave the White House for a vacation in August 1998.
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President Clinton makes a statement at the White House in December 1998, thanking members of Congress who voted against his impeachment. The Senate trial ended with an acquittal in February 1999.
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Clinton announces in February 2000 that she will seek the U.S. Senate seat in New York. She was elected later that year.
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Clinton makes her first appearance on the Senate Environment and Natural Resources Committee.
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Sen. Clinton comforts Maren Sarkarat, a woman who lost her husband in the September 11 terrorist attacks, during a ground-zero memorial in October 2001.
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Clinton holds up her book "Living History" before a signing in Auburn Hills, Michigan, in 2003.
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Clinton and another presidential hopeful, U.S. Sen. Barack Obama, applaud at the start of a Democratic debate in 2007.
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Obama and Clinton talk on the plane on their way to a rally in Unity, New Hampshire, in June 2008. She had recently ended her presidential campaign and endorsed Obama.
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Obama is flanked by Clinton and Vice President-elect Joe Biden at a news conference in Chicago in December 2008. He had designated Clinton to be his secretary of state.
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Clinton, as secretary of state, greets Russian Prime Minister Vladimir Putin during a meeting just outside Moscow in March 2010.
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The Clintons pose on the day of Chelsea's wedding to Marc Mezvinsky in July 2010.
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In this photo provided by the White House, Obama, Clinton, Biden and other members of the national security team receive an update on the mission against Osama bin Laden in May 2011.
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Clinton checks her Blackberry inside a military plane after leaving Malta in October 2011. In 2015, The New York Times reported that Clinton exclusively used a personal email account during her time as secretary of state. The account, fed through its own server, raises security and preservation concerns. Clinton later said she used a private domain out of "convenience," but admits in retrospect "it would have been better" to use multiple emails.
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Clinton arrives for a group photo before a forum with the Gulf Cooperation Council in March 2012. The forum was held in Riyadh, Saudi Arabia.
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Obama and Clinton bow during the transfer-of-remains ceremony marking the return of four Americans, including U.S. Ambassador Christopher Stevens, who were killed in Benghazi, Libya, in September 2012.
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Clinton ducks after a woman threw a shoe at her while she was delivering remarks at a recycling trade conference in Las Vegas in 2014.
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Clinton, now running for President again, performs with Jimmy Fallon during a "Tonight Show" skit in September 2015.
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Clinton testifies about the Benghazi attack during a House committee meeting in October 2015. "I would imagine I have thought more about what happened than all of you put together," she said during the 11-hour hearing. "I have lost more sleep than all of you put together. I have been wracking my brain about what more could have been done or should have been done." Months earlier, Clinton had acknowledged a "systemic breakdown" as cited by an Accountability Review Board, and she said that her department was taking additional steps to increase security at U.S. diplomatic facilities.
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U.S. Sen. Bernie Sanders shares a lighthearted moment with Clinton during a Democratic presidential debate in October 2015. It came after Sanders gave his take on the Clinton email scandal. "The American people are sick and tired of hearing about the damn emails," Sanders said. "Enough of the emails. Let's talk about the real issues facing the United States of America."
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Clinton is reflected in a teleprompter during a campaign rally in Alexandria, Virginia, in October 2015.
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Clinton walks on her stage with her family after winning the New York primary in April.
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After Clinton became the Democratic Party's presumptive nominee, this photo was posted to her official Twitter account. "To every little girl who dreams big: Yes, you can be anything you want -- even president," Clinton said. "Tonight is for you."
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Obama hugs Clinton after he gave a speech at the Democratic National Convention in Philadelphia. The president said Clinton was ready to be commander in chief. "For four years, I had a front-row seat to her intelligence, her judgment and her discipline," he said, referring to her stint as his secretary of state.
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Clinton arrives at a 9/11 commemoration ceremony in New York on September 11. Clinton, who was diagnosed with pneumonia two days before, left early after feeling ill. A video appeared to show her stumble as Secret Service agents helped her into a van.
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Clinton addresses a campaign rally in Cleveland on November 6, two days before Election Day. She went on to lose Ohio -- and the election -- to her Republican opponent, Donald Trump.
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After conceding the presidency to Trump in a phone call earlier, Clinton addresses supporters and campaign workers in New York on Wednesday, November 9. Her defeat marked a stunning end to a campaign that appeared poised to make her the first woman elected US president.
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That is a message likely to be adopted in other Senate races that could decide control of the chamber, including Sen. Kelly Ayotte’s uphill re-election battle in New Hampshire and Sen. Richard Burr’s tough fight in North Carolina.
Higher premium hikes in states such as Florida – a vital battleground where Clinton and Trump campaigned on Tuesday – and Colorado could also shape the political narrative in the run-up to election day.
And Clinton’s push into Arizona, a red state that Democrats believe they can pluck from Trump on Election Day, is now facing a new obstacle following news that Obamacare premiums could rise 116%.
But there is no guarantee Obamacare’s new problems will necessarily be a slam dunk for Republicans. A CNN/ORC poll published Monday showed that health care was only the fifth most important issue motivating voters this year, behind other concerns including the economy, immigration, foreign policy and terrorism.
Another factor that could diminish the impact of the latest Obamacare travails is the unconventional nature of this election, which at this late stage seems to be turning far more on Trump’s personality and temperament than a detailed discussion of policy issues.
Perhaps the biggest hurdle to Obamacare’s latest woes swaying the election is the tight calendar – the election is just 13 days away. Millions of voters have already made up their mind about Trump and Clinton and cast early ballots.
Former White House press secretary Jay Carney, who spent long hours defending Obamacare from the briefing room, admitted the law was not as popular as the president would like it to be. But he said voters would give Clinton credit for trying to repair it.
“Is it something …. that’s going to change the election? No, it’s not,” Carney said on CNN’s “New Day” on Tuesday. “Remember, the opportunity Republicans had to use Obamacare against the Democrats and win the White House was in 2012. Mitt Romney, a far more credible candidate for president of the United States from the Republican Party, you know, beat us hard over the head with Obamacare.”
“And guess what,” Carney continued. “The American people re-elected President Obama.”
