Health Affairs January 29, 2020
Richard Hughes IV

As the campaign for the Democratic nomination continues, candidates are touting their health care platforms. While Senators Bernie Sanders and Elizabeth Warren support plans to transition into a system of Medicare for All, Vice President Joe Biden and South Bend, Indiana, Mayor Pete Buttigieg have released platforms that intend to build upon the Affordable Care Act (ACA). Democratic candidate platforms tend to focus solely on policy options to “shore up” the ACA by expanding the availability of health coverage through Medicare, Medicaid, qualified health plans (QHPs) on the exchanges, and establishment of a public option.

While these policies are top of mind in the public discourse on health care, other provisions of the ACA could be strengthened significantly, including one...

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