Dear Friends,
We are in the throes of election season, and some of you may be wondering what the differences are between the Democrat and Republican proposals to fix our healthcare system. I’m happy to outline them here:
Democratic platform: This has changed recently with the nomination of Joe Biden. The current Democratic platform proposes a “public option” in addition to existing coverage options. (It does not endorse a Medicare-for-All model). Under this plan, a federal agency would administer the public option directly; private insurance companies would have no role (or profit). The agency would negotiate with pharmaceutical companies to establish formularies and lower drug prices. All plans would cover primary care with no co-payments and at least one public option plan would be available without a deductible. Low-income individuals would be automatically enrolled in the public option with no premium, though they could opt out of such coverage if they prefer.
The platform also lowers the age at which one is eligible for Medicare. When individuals turn 60, they could choose to enroll in the public option or in the Medicare program. Democrats would block branded and generic manufacturers from increasing prices faster than the rate of inflation, and establish a cap on Medicare beneficiaries’ out of pocket drug costs.
The platform includes measures to expand access to primary care and mental and behavioral health services, with expanding the workforce for each. Finally, the platform reverses current Administration regulations that allow health care providers to discriminate against members of the LGBTQ+ community.
Republican platform: There is no plan. But, based on their “repeal and replace” efforts over the last several years, we can expect Republican elected officials to continue to try to repeal Medicaid expansion (which has insured 14 million additional people since 2014), as well as the subsidies that help lower the cost of insurance. In their 2017 proposal, they planned to take some, but not all of the money that was saved by doing this and send it to the states, to let them design their own programs. Since then, they haven’t advanced any concrete new proposals. However, a Republican Study Committee in 2019 issued a document which included the above proposals and added that insurers could exclude pre-existing conditions from coverage for 12 months. Insurers would have no limit on their profit margin, as they do now, and could charge more for people with pre-existing conditions. It would also undo all current regulations mandating 10 essential health benefits, free preventive screenings and dependent coverage.
I hope that this information will help you make an informed decision come November 3.
Yours in good health,
Renata Marinaro
Do you work in performing arts and entertainment and have questions about health insurance? The Actors Fund provides assistance nationally. Contact our regional office closest to you to speak to a counselor.
New York City
917.281.5975
Los Angeles
855.491.3357
Don’t forget to use the resources section of our website. It contains tools to help you make decisions about your health insurance, including new online tutorials on how to choose providers and how to read an Explanation of Benefits. In addition, you’ll find an updated Stage Managers National Health Directory, our national online directory of health care providers recommended by industry professionals that can be used by theaters and touring companies. For these resources and more, visit actorsfund.org/HealthServices. You can also find out more about enrollment assistance and upcoming health insurance seminars near you!