(Reuters) – Democratic presidential candidate Joe Biden wants to expand the Affordable Care Act, President Barack Obama’s signature healthcare legislation, and then name it after himself.
Republican President Donald Trump wants to end it altogether, and replace it with something that has yet to be defined.
An ongoing debate over which approach is better for the economy is partly about price tags. Bidencare is forecast to increase federal healthcare spending by $2 trillion or more over 10 years. Trump’s approach is to hold federal spending stable or reduce it.
Bidencare supporters emphasize the stimulative effects of government spending, especially in a period of economic distress, and the benefits of insuring more people in the middle of a pandemic. Those who prefer Trump’s approach say it would avoid debt or tax increases they say would drag on future economic growth.
The United States has about 30 million people without health insurance https://tmsnrt.rs/3mzqQxC now, down from about 46.5 million in 2010, when the ACA was passed.
Graphic – Under ACA, a drop in the number of uninsured: https://graphics.reuters.com/USA-ELECTION/ECONOMY-HEALTHCARE/rlgpdxbompo/chart.png
Bidencare would cut that figure by a further 15 million to 20 million, an analysis by the Committee for a Responsible Federal Budget estimates. Trump isn’t expected to try to reduce that.
Healthcare spending is equal to 17% of the U.S. economy, far more than any other industrialized country, so the Trumpcare vs. Bidencare debate is no small economic matter. It’s further complicated by the fact that extra spending doesn’t translate to a healthier populace than other counties.
“Improving healthcare performance is a critical part of strengthening America’s health, economy and fiscal future, and should be top a priority for the next president and Congress,” says Peterson Foundation CEO Michael Peterson.
BIDENCARE FOCUSES ON LOWER-INCOME AMERICANS
Bidencare would cover more Americans by increasing subsidized health insurance purchases through tax credits.
It would also offer a “public option,” allowing anyone who wants it to buy in, even if their job offers private insurance. Lower-income families shut out of ACA’s expanded Medicaid eligibility because of where they live could get it premium-free.
Any boost to health and financial stability is likely to be biggest for millions of low-income households, particularly Latino and Black families who have been particularly hard-hit during the pandemic.
For these groups especially, says the University of Michigan School of Public Health’s Helen Levy, being able to accumulate assets “is really important if you think about supporting economic mobility.”
Minorities get and die from COVID-19 at higher rates than whites, data shows. Some of that is probably because Blacks and Latinos are more likely to work in jobs that put them at higher risk of transmission.
But even without COVID-19, minorities face higher rates of chronic disease and earlier death than whites. They also have lower rates of health insurance despite substantial gains since the advent of the ACA, a study by Kaiser Family Foundation shows.
Biden said he would pay for his plan through higher taxes on the wealthy, and use the clout of expanded public insurance to keep down medical costs.
Increasing the number of insured Americans could have positive economic consequences.
There’s evidence that the uninsured who do get sick get care in expensive settings like the emergency room, says UCLA public health policy professor Gerald Kominski. That takes a toll on their financial health and, when they can’t pay, strains the finances of hospitals that provide their care, with taxpayers footing part of that bill as well.
People in states where uninsured rates fell under Obamacare had fewer past-due debts, were less likely to use payday loans or file for bankruptcy, had better credit and were less likely to be evicted than those in states that did not expand Medicaid eligibility under the ACA.
“The whole reason people should get insurance, from an economist’s perspective, is to protect them against catastrophic losses,” says University of Minnesota professor Sayeh Nikpay.
TRUMPCARE LESS CLEAR, BUT CHEAPER
Trump tried and failed to get Congress to repeal the ACA in his first four-year term, and is likely to continue to it in some form during a second term.
The Supreme Court is scheduled to hear a challenge to the law a week after Tuesday’s presidential election. A ruling to dismantle the ACA would put coverage of 21 million Americans in jeopardy, according to the Urban Institute, though most legal scholars don’t expect the court to do so.
If it does, Trump hasn’t specified a plan to replace it. One blueprint may be the Health Care Choices Proposal, put together by conservative health policy experts at the Galen Institute and the Heritage Foundation.
The plan would turn money now used for the ACA over to states to help people buy private health insurance and to provide coverage for low-income households.
An analysis by the right-leaning nonprofit think tank American Action Forum found the proposal would lower premiums by 18% to 24%. The number of uninsured would remain steady.
“The macroeconomic effects would be better than either current law or proposals to devote more public resources to the ACA,” says author Doug Badger. Reducing premiums, he said, would be the “best form of economic stimulus” because it would put money in the pockets of regular Americans.
That analysis is disputed.
Bidencare’s high price tag does worry Bipartisan Policy Center Senior Vice President William Hoagland, a former staffer to Republican lawmakers. But, he said, it’s worth paying for broader health insurance access, which he said would lead to a stronger economy.
“I’m going to come down on the side that a healthy country, and a reduction in chronic conditions, improves productivity, and improving productivity increases economic growth,” he said.
(Reporting by Ann Saphir; Editing by Heather Timmons and Jonathan Oatis)
OTTAWA – Canada’s unemployment rate held steady at 6.5 per cent last month as hiring remained weak across the economy.
Statistics Canada’s labour force survey on Friday said employment rose by a modest 15,000 jobs in October.
Business, building and support services saw the largest gain in employment.
Meanwhile, finance, insurance, real estate, rental and leasing experienced the largest decline.
Many economists see weakness in the job market continuing in the short term, before the Bank of Canada’s interest rate cuts spark a rebound in economic growth next year.
Despite ongoing softness in the labour market, however, strong wage growth has raged on in Canada. Average hourly wages in October grew 4.9 per cent from a year ago, reaching $35.76.
Friday’s report also shed some light on the financial health of households.
According to the agency, 28.8 per cent of Canadians aged 15 or older were living in a household that had difficulty meeting financial needs – like food and housing – in the previous four weeks.
That was down from 33.1 per cent in October 2023 and 35.5 per cent in October 2022, but still above the 20.4 per cent figure recorded in October 2020.
People living in a rented home were more likely to report difficulty meeting financial needs, with nearly four in 10 reporting that was the case.
That compares with just under a quarter of those living in an owned home by a household member.
Immigrants were also more likely to report facing financial strain last month, with about four out of 10 immigrants who landed in the last year doing so.
That compares with about three in 10 more established immigrants and one in four of people born in Canada.
This report by The Canadian Press was first published Nov. 8, 2024.
The Canadian Institute for Health Information says health-care spending in Canada is projected to reach a new high in 2024.
The annual report released Thursday says total health spending is expected to hit $372 billion, or $9,054 per Canadian.
CIHI’s national analysis predicts expenditures will rise by 5.7 per cent in 2024, compared to 4.5 per cent in 2023 and 1.7 per cent in 2022.
This year’s health spending is estimated to represent 12.4 per cent of Canada’s gross domestic product. Excluding two years of the pandemic, it would be the highest ratio in the country’s history.
While it’s not unusual for health expenditures to outpace economic growth, the report says this could be the case for the next several years due to Canada’s growing population and its aging demographic.
Canada’s per capita spending on health care in 2022 was among the highest in the world, but still less than countries such as the United States and Sweden.
The report notes that the Canadian dental and pharmacare plans could push health-care spending even further as more people who previously couldn’t afford these services start using them.
This report by The Canadian Press was first published Nov. 7, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
As Canadians wake up to news that Donald Trump will return to the White House, the president-elect’s protectionist stance is casting a spotlight on what effect his second term will have on Canada-U.S. economic ties.
Some Canadian business leaders have expressed worry over Trump’s promise to introduce a universal 10 per cent tariff on all American imports.
A Canadian Chamber of Commerce report released last month suggested those tariffs would shrink the Canadian economy, resulting in around $30 billion per year in economic costs.
More than 77 per cent of Canadian exports go to the U.S.
Canada’s manufacturing sector faces the biggest risk should Trump push forward on imposing broad tariffs, said Canadian Manufacturers and Exporters president and CEO Dennis Darby. He said the sector is the “most trade-exposed” within Canada.
“It’s in the U.S.’s best interest, it’s in our best interest, but most importantly for consumers across North America, that we’re able to trade goods, materials, ingredients, as we have under the trade agreements,” Darby said in an interview.
“It’s a more complex or complicated outcome than it would have been with the Democrats, but we’ve had to deal with this before and we’re going to do our best to deal with it again.”
American economists have also warned Trump’s plan could cause inflation and possibly a recession, which could have ripple effects in Canada.
It’s consumers who will ultimately feel the burden of any inflationary effect caused by broad tariffs, said Darby.
“A tariff tends to raise costs, and it ultimately raises prices, so that’s something that we have to be prepared for,” he said.
“It could tilt production mandates. A tariff makes goods more expensive, but on the same token, it also will make inputs for the U.S. more expensive.”
A report last month by TD economist Marc Ercolao said research shows a full-scale implementation of Trump’s tariff plan could lead to a near-five per cent reduction in Canadian export volumes to the U.S. by early-2027, relative to current baseline forecasts.
Retaliation by Canada would also increase costs for domestic producers, and push import volumes lower in the process.
“Slowing import activity mitigates some of the negative net trade impact on total GDP enough to avoid a technical recession, but still produces a period of extended stagnation through 2025 and 2026,” Ercolao said.
Since the Canada-United States-Mexico Agreement came into effect in 2020, trade between Canada and the U.S. has surged by 46 per cent, according to the Toronto Region Board of Trade.
With that deal is up for review in 2026, Canadian Chamber of Commerce president and CEO Candace Laing said the Canadian government “must collaborate effectively with the Trump administration to preserve and strengthen our bilateral economic partnership.”
“With an impressive $3.6 billion in daily trade, Canada and the United States are each other’s closest international partners. The secure and efficient flow of goods and people across our border … remains essential for the economies of both countries,” she said in a statement.
“By resisting tariffs and trade barriers that will only raise prices and hurt consumers in both countries, Canada and the United States can strengthen resilient cross-border supply chains that enhance our shared economic security.”
This report by The Canadian Press was first published Nov. 6, 2024.
