One day before the Iowa caucus, Sen. Ted Cruz of Texas slammed Republican rival Donald Trump on NBC’s Meet the Press by lumping him in with the Democrats.
"Donald Trump and Hillary Clinton and Bernie Sanders have the identical position on health care," Cruz said on Jan. 31. "Which is they want to put the government in charge of you and your doctor."
Trump, who’s leading Cruz by almost six points in Iowa, called Cruz a liar on ABC’s This Week. But is Cruz right that the Republican front runner has the health care plan as the two leading Democrats?
Not exactly. Trump, Clinton and Sanders all seem to support one particular health care policy: allowing the government to negotiate drug prices. Beyond that specific proposal, however, the three candidates’ overarching positions on health care are not at all "identical" and, one could argue, actually contradictory.
Let’s examine each candidate’s health care plan, starting with Sanders'.
Sanders’ single-payer system
One of the central platforms of Sanders’ agenda is his proposal for universal health care under a single-payer system.
Sanders seeks to expand Medicare — the health safety net that covers those over 65 — to all Americans. The plan, which is described in detail on Sanders’ website, "will cover the entire continuum of health care."
"As a patient, all you need to do is go to the doctor and show your insurance card," the proposal reads. "Bernie’s plan means no more copays, no more deductibles and no more fighting with insurance companies when they fail to pay for charges."
To pay for the $1.38 trillion plan, Sanders is proposing a 6.2 percent payroll tax, a 2.2 percent income-based premium tax and a slew of taxes for higher income households. Sanders argues that a single-payer system would give the government leverage to trim administrative costs and drug prices. But it’s not clear those significant tax increases and cost reductions would cover the costs of his plan.
Clinton to defend Obamacare
Clinton, who says single-payer "will never, ever come to pass," proposes instead to hold up and build upon the Affordable Care Act.
According to her website, Clinton will defend President Barack Obama’s 2010 landmark health care law, also called Obamacare, from efforts to repeal it. She also wants to expand health care access for rural Americans and work to lower the costs of deductibles, copays and prescription drugs.
Specifically, she proposes:
• Exempting three doctor's visits per year from deductibles;
• Providing a refundable tax credit (up to $2,500 for individuals, $5,000 for families) for Americans whose out-of-pocket health care expenses are more than 5 percent of their income;
• Blocking or modifying unreasonable insurance rate hikes.
Trump’s ambiguous plan
Trump, who once voiced admiration for single-payer, has yet to release a health care plan or propose anything beyond vague suggestions. But Trump consistently has said he would repeal the Affordable Care Act — a position contradicting Clinton’s vow.
Obamacare would be replaced with "something terrific" that "takes care of everybody," Trump promises but swears now that it wouldn’t be a single-payer system — a position antithetical to Sanders’ plan.
What that "something terrific" would actually look like is unclear. His comments over the past few months suggests he’s been adding to a grab bag of sometimes contradictory ideas.
Trump has suggested a health care system in which insurance companies deemed financially stable can offer plans across state lines. He’s also advocated for the government to negotiate with hospitals and drug companies for lower prices and to provide coverage for lower income Americans. Here are some examples of what he’s proposed:
• Jan. 31, 2016, This Week: "We're going to work with our hospitals. We're going to work with our doctors. We've got to do something. …But that's not single payer and as far as Obamacare is concerned, one of the staples of my speech — and you can ask any of my many supporters — is repeal and replace Obamacare. It's a disaster.
• Jan. 25, 2016, Farmington, N.H., rally: "Drugs, with Medicare — they don’t bid them out, they don’t bid them out. They pay like this wholesale incredible number. They say like $300 billion could be saved if we bid them out. We don’t do it. Why? Because of the drug companies, folks."
• Oct. 25, 2015, This Week: "I'm okay with the (health) savings accounts. I think it's a good idea; it's a very down-the-middle idea. It works. It's something that's proven. The one thing we have to do is repeal and replace Obamacare. It is a disaster."
• Oct. 14, 2015, WHO Radio: "If we get rid of the artificial lines drawn around each state and companies from Iowa can bid in New York … you’ll get these great plans. And the only thing the government should be involved in is they have to be really solvent companies in case there’s a catastrophic event or whatever. As far as the other group, as far as what we can do, I don’t want to see people doing in the streets."
• Sept. 27, 2015, 60 Minutes: "Obamacare's going to be repealed and replaced. ...I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now. ...The government's going to pay for it. But we're going to save so much money on the other side. But for the most part, it's going to be a private plan, and people are going to be able to go out and negotiate great plans with lots of different competition, with lots of competitors, with great companies, and they can have their doctors, they can have plans, they can have everything."
Cruz said, "Donald Trump and Hillary Clinton and Bernie Sanders have the identical position on health care, which is they want to put the government in charge of you and your doctor."
While Trump, Clinton and Sanders have all proposed to reduce prescription drug prices, that one policy is a far cry from having "the identical position on health care." Cruz’s description of that position (putting the government in charge of you and your doctor) can only reasonably be applied to Sanders’ single-payer system.
Clinton has proposed specific ways to defend and expand Obama’s health care law. Trump, whose exact plan is unclear, has said repeatedly that he’d repeal and replace Obamacare with a market-based alternative.
To suggest that Trump, Clinton and Sanders have the same health care proposal is inaccurate. There are many specific differences between the three plans. We rate Cruz’s statement False.