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March 4, 2020

Biden just had a big Super Tuesday. See where he stands on health care.

Daily Briefing

    Former Vice President Joe Biden appears to have gained momentum in the Democratic presidential race on Super Tuesday—and unlike some other Democratic candidates, he has touted an approach to health care reform that pursues a so-called "public option" rather than a single-payer system.

    Super Tuesday results

    Biden as of Wednesday morning appeared to have won nine states that voted on Super Tuesday: Alabama, Arkansas, Massachusetts, Minnesota, North Carolina, Oklahoma, Tennessee, Texas, and Virginia.

    Meanwhile, Sen. Bernie Sanders (I-Vt.) won three states: Colorado, Utah, and Vermont. Former New York City Mayor Michael Bloomberg, who suspended his presidential campaign Wednesday morning, won the caucuses in American Samoa, while the other two major candidates in the race—Rep. Tulsi Gabbard (D-Hawaii) and Sen. Elizabeth Warren (D-Mass.)—did not walk away with any Super Tuesday victories.

    California and Maine had yet to be called at the time of publishing but, according to the New York Times, Sanders as of Wednesday morning led Biden by 8.8 percentage points in California. In Maine, Biden narrowly led Sanders by 1 percentage point.

    Even if Sanders notches a victory in California, NBC News reports that Biden, age 77, is likely to be the Super Tuesday delegate winner.

    Where does Biden stand on health care?

    Throughout the Democratic presidential campaign, Biden has taken a more moderate approach toward health care reform than many of his rivals. He has particularly criticized Sanders' so-called "Medicare-for-All" plan, which would largely eliminate private health insurance in the United States. Instead, Biden favors a public option health plan to build on and protect the Affordable Care Act (ACA).

    See where all of the 2020 Democratic presidential candidates stand on health care

    Health reform

    Biden's plan, which he unveiled in July, calls for creating a new public option health insurance plan that would compete with private health plans on the market. The public plan would be available to all Americans, including individuals whose employers offer health coverage. But unlike proposals being touted by Sanders and Warren, Biden’s plan would not eliminate employer-sponsored coverage.

    Individuals with incomes below 138% of the federal poverty level (FPL) would be automatically enrolled in the public health plan during their interactions with public schools or other federal programs for individuals with low incomes. This would be a boon for states that have not yet expanded their Medicaid programs under the ACA, as states that have expanded Medicaid would have to continue footing the bill for their expanded programs. Biden’s proposal would cap premiums at 8.5% of household income.   

    Biden's proposal also would make more Americans eligible for the ACA's subsidies to help offset the cost of purchasing an exchange plan by eliminating the 400% income cap.

    Prescription drugs

    Biden's health care plan also seeks to reduce the costs of prescription drugs by repealing federal laws that prohibit Medicare from negotiating lower drug prices with drug manufacturers—a proposal that many Republican lawmakers have so far opposed. Biden's plan also would:

    • Allow Americans to purchase prescription drugs from other countries;
    • Eliminate tax breaks given to pharmaceutical corporations for advertising spending;
    • Establish an independent review board to link the prices of new specialty drugs to the average price in foreign countries;
    • Restrict launch prices for prescription drugs with no competition on the market; and
    • Restrict price increases over the general inflation rate.

    Surprise medical bills

    Biden's health care plan also calls for a fix to address so-called "surprise" medical bills. Biden's plan states that it would "bar health care providers from charging patients out-of-network rates when the patient doesn't have control over which provider the patient sees." However, it does not state whether Biden favors a benchmark payment rate or arbitration solution, both of which are being debated in Congress. Lawmakers have released several proposals to address surprise medical bills, but so far have yet to come to a consensus on whether to create a benchmark payment rate, implement an arbitration process, or adopt a combined approach.

    Rural health care

    Biden in July also released a proposal to improve health care in rural America by building on the ACA. The proposal is light on specifics but calls for increasing funding for community health centers, increasing grant funding to build rural hospitals and expand telehealth services, and drawing more doctors to rural areas through better funded medical residencies.

    Biden's proposal also touts several provisions in the Save Rural Hospitals Act that aim to boost rural hospital payments, eliminate unnecessary federal regulations that hamper rural care, and create a new Community Outpatient Hospital designation to ensure rural communities have access to 24/7 emergency care.

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