Where Presidential Candidates Stand on Senior Issues

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Q. I am having a hard time following where the candidates stand on Social Security, Medicare, and Medicaid. I watched all the debates so far, and typically vote based on the person, not the party. If you know more about their stances on these issues, can you provide an apples-to-apples view on where they all stand, so I can make an informed decision. Thanks very much for your help!

A. When it comes to Social Security, Medicare, and Medicaid, there are clear differences between the Democratic and Republican candidates. Information is all over the place, and I agree with you that it is important to know where candidates stand when it comes to senior programs to help us decide how to vote in the upcoming primaries and the presidential election in the fall. So, let's examine the positions taken by the leading 2016 presidential candidates on these topics, using the chart below. For Republicans, we will focus on the top 4 candidates, based on the most recent polls, and will focus only on Medicare and Social Security in this part (Part 2 will include details on Medicaid.) Information in the chart is derived from OntheIssues.com, Boston College's Center for Retirement Research, various articles for which I provided the links, and candidate's websites.
 

Candidate	Issue	View
Democrats
Hillary Clinton	Medicare and the Affordable Care Act (ACA)	Clinton: • supports the ACA and will defend it against efforts to appeal it; • opposes privatization of Medicare or phasing it out; • would allow Medicare to negotiate prescription drugs costs to help drive down their costs; • advocates Medicare delivery reforms to improve value and quality of care. Read more here.
	Social Security	Clinton believes that Social Security must remain what it has always been: a rock-solid benefit that seniors can always count on—not subject to the budget whims of Congress or to the fluctuations of the stock market.   She would:   • fight any attempts to gamble seniors’ retirement security on the stock market through privatization; • oppose reducing annual cost-of-living adjustments; • oppose Republican efforts to raise the retirement age—an unfair idea that will particularly hurt the seniors who have worked the hardest throughout their lives; • oppose closing the long-term shortfall on the backs of the middle class, whether through benefit cuts or tax increases.
Bernie Sanders	Medicare and the Affordable Care Act (ACA)	Sanders: • would allow Medicare to negotiate prescription drug costs and allow drugs to be imported from Canada, in an effort to drive down costs; • would restore discounts to seniors under Medicare Part D, and would close the Medicare donut hole in 2017, three years earlier than the current schedule.   Sanders has been quoted as supporting the ACA and the goal of universal coverage. He'd go a step farther and implement a single-payer system, basically "Medicare for all."
	Social Security	Sanders: • opposes any reductions to Social Security benefits, opposes increasing the retirement age and opposes privatization; • would strengthen Social Security funding by raising the system's taxable wage base to $250,000 (it will be $118,500 in 2016). Watch his video for more details on his views on this issue.
Republicans
Donald Trump	Medicare and the Affordable Care Act (ACA)	Trump opposes cuts to Medicare and supports repeal of the ACA. He doesn't appear to take any position on a potential replacement for the ACA, which would mean a return to the pre-2014 days regarding pre-age 65 retiree health coverage. Notably, Trump is the only republican candidate who vows to expand economic growth enough that cuts in Medicaid will be unnecessary.
	Social Security	Trump opposes cuts to Social Security and opposes raising the retirement age.
Ben Carson	Medicare and the Affordable Care Act (ACA)	Carson has previously said he would dismantle the national social insurance program for the elderly (Medicare) and replace it with a private voucher system. He recently changed his mind when asked on Facebook if he wanted to abolish Medicare and said he'll soon offer a plan to "save money and deliver better service to our nation's seniors." He'd use Health Savings Accounts (HSAs) to reduce the need for government assistance programs, such as Medicare and Medicaid. He's also been quoted as saying Obamacare is the "worst thing since slavery." While Carson apparently is in favor of repealing the ACA, he does not appear to have suggested specific proposals to replace the ACA and, in particular, provide for universal coverage or prohibit exclusions due to pre-existing conditions.
	Social Security	Carson proposes to: • allow workers to invest a portion of their payroll taxes in a personal account; • gradually raise the age at which benefits are distributed; • forbid the government from reallocating any of the money that has been set aside for Social Security. Read more here.
Ted Cruz	Medicare and the Affordable Care Act (ACA)	Cruz would raise Medicare's eligibility age to save costs. He advocates repeal of the ACA and has actively fought its implementation. He has proposed the Health Care Choice Act as an alternative to ACA, although it's unclear if it allows universal coverage and prohibition of exclusions due to pre-existing conditions.
	Social Security	Cruz proposes: • allowing workers to invest a portion of their payroll taxes in a personal account; • gradually increasing the retirement age; • changing the rate of increase in benefits so that it matches inflation, rather than exceeding inflation. Read more here.
Marco Rubio	Medicare and the Affordable Care Act (ACA)	Rubio would make no changes for those in retirement or near retirement. He would transition Medicare to a premium support system, which would give seniors a fixed amount to purchase health insurance. They could have the option of either Medicare or a private provider. Rubio would repeal the ACA. On his site, he states that he'd provide all Americans with a tax credit that can be used to purchase private insurance, although he has no stated position on whether insurance companies can allow exclusions for pre-existing conditions
	Social Security	Rubio proposes that we: • gradually increase the retirement age for individuals under 55, without changing it for current seniors; • reduce the growth of benefits for upper income seniors while making the program even stronger for lower-income seniors; • empower people to save more for retirement. Read more here.

I hope you find this to be helpful! Stay tuned as the presidential campaign heats up and the candidates continue to refine their positions about these issues. We will continue to keep our readers updated!

Have you planned for your future and for your loved ones? Regardless of the election outcome or possible changes in the law, the need to plan in advance remains. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning (or had your documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please don’t hesitate to call us as soon as possible for a no-cost initial consultation:

Fairfax Elder Law: 703-691-1888
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Critter Corner: What are the free preventative health services provided under the Affordable Care Act (ACA) Again?



Dear Angel,

I have been paying close attention to the 2016 campaign, and the candidates views on Medicare and the ACA. Then, I got to thinking. I have never used any of the free preventative services that resulted from the ACA. If it could be repealed in the future, I better start taking advantage of them! Can you remind me about what they are?

Thanks,

A.C. Ayye

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Dear A.C.,

The ACA mandates expanded preventive health services for all Americans, including Medicare beneficiaries.

Under the ACA rules, a free yearly wellness exam is available from doctors who participate in Medicare. The wellness exam supplements a one-time “Welcome to Medicare” exam that is free to people who take advantage of it within their first 12 months of Medicare coverage.  Medicare has details on the preventive measures it covers. Below are the Medicare preventive and wellness items that are free. Ideally, they should be part of an ongoing wellness plan that you and your physician develop.

Below are examples of preventative services covered by the ACA:

• Abdominal aortic aneurysm screening

• Bone mass measurement

• Flu shots

• Hepatitis B shots

• Breast cancer screening (mammograms)

• Medical nutrition therapy services (for those with diabetes or kidney disease)

• Pap tests and pelvic exams (includes clinical breast exam; once every 24 months or once every 12 months for at-risk women)

• One-time “Welcome to Medicare” physical exam

• Yearly “wellness” exam (for people with Part B Medicare longer than 12 months)

• Pneumococcal shot

• Smoking cessation (counseling to stop smoking; for those not previously diagnosed with an illness caused or complicated by tobacco use)

The Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, provides a general set of wellness tips for women and men above the age of 50.

Be sure to take advantage of these important, no-cost procedures offered as a result of the ACA, as part of a wellness plan formulated by you and your doctor.

Purrs,

Angel


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