The pre-Covid-19 reality
In February 2020—just weeks before the United States shut down in the face of the Covid-19 pandemic—respondents to a national survey ranked ‘lowering the cost of health care’ as the highest domestic priority for both the President and Congress. This focus on affordability is nothing new; national health expenditure as a share of gross domestic product has been rising consistently since 1960, and now accounts for 17.7% of the GDP. President Nixon addressed Congress about the growing cost of health care back in 1974, and President Obama echoed those sentiments 35 years later when he made health care access a cornerstone of his administration.
With the majority of Americans last year reporting at least one medical financial hardship, candidates for this year’s presidential election had been centering their health care priorities around reducing costs to patients. There are some areas of consensus: both President Donald Trump and former Vice President Joe Biden have spoken out against high drug prices and costly surprise bills.
Coming into this year, the primary disagreement between the candidates was centered on coverage. Biden believes a Public Option—building on the coverage expansions of the Affordable Care Act—is the path to affordable, accessible health care. Trump continues to voice opposition to the Affordable Care Act, and instead favors offering a broad array of health insurance options, including association and short-term health plans, without mandating coverage.