“Repeal and replace” is the sound bite synthesis of the Republican stance on health care, with each candidate vying to be the most against the Affordable Care Act (ACA). While it has become clear what the candidates are against, in the midst of all the insult-slinging and fanfare that has characterized the Republican debates this election season, it isn't quite as obvious what they are for. Below we break down what patients and providers might expect health care to look like under a President Trump, Cruz, or Rubio.
We don't win in any capacity with health care. We have terrible health care, Obamacare is going to be repealed and replaced. We just don't win. - Donald Trump
Donald Trump's health care plan is vague, comprised mostly of biting condemnations of the ACA and proclamations of how he will replace it with something better. When pressed during the debate on February 25 on the specifics of the plan, Trump offered that he would keep the ACA's mandate that insurance companies cannot deny coverage or charge more based on preexisting conditions. He also insisted that “We have to get rid of the lines around the states so that there's serious, serious competition.”
But, as Ted Cruz has pointed out, this contradicts Trump's earlier statements in a 2015 60 Minutes interview that he is “going to take care of everybody” and “the government's going to pay for it.”
I will repeal every word of Obamacare. -Ted Cruz
Before his bid for the presidency, Texas Senator Ted Cruz was best known for his hand in the 2013 government shut down and his 21 hour speech against the ACA, which included a reading of Green Eggs and Ham. Upon repealing the ACA entirely, Cruz plans to make coverage more affordable by opening up the marketplace so that insurance plans can be purchased across state lines. Cruz will also expand Health Savings Accounts (HSAs). Cruz's plan makes coverage “personal” and “portable” so that people can keep their health insurance even if they lose their jobs.
When they passed Obamacare, they put a bailout fund in Obamacare...we led the effort and wiped out that bailout fund. The insurance companies are not in favor of me, they hate that. -Marco Rubio
Marco Rubio has the distinction among the top three Republican candidates of being the only one who specifically addresses health care, as an issue on his website. The Florida Senator claims to have saved taxpayers $2.5 billion by leading the effort against an Obamacare 'bailout'—a risk corridor provision in the law that would help make up for the losses of insurers who estimated their premiums too low with the profits from those who estimated too high. In 2015, when enough profits weren't collected, Republicans blocked the administration from moving funds in the budget, which left a deficit in the risk corridor program and has contributed to the closure of health care, cooperatives across the country.
Despite his leadership in the fight against the ACA, Rubio's plan resembles it the most. Rubio will provide low-cost, high-quality health care, by giving everyone a tax credit with which to purchase insurance, reforming insurance regulations, putting protections in place for those with preexisting conditions, and reforming Medicaid through a grant program that releases states from Federal mandates.–Katie Grosso