Where Trump and Biden Stand on Issues Important to Older Americans

With the presidential election only a few weeks away -- and early voting already underway in many states -- it is important for voters to know the candidates’ positions on issues like Medicare, Medicaid, and Social Security. 

Social Security
President Trump has issued an executive order deferring payroll (including Social Security) taxes until the end of the year as a form of economic relief, and he has said he will forgive repayment of the tax if he is reelected.  This could reduce the solvency of the Social Security Trust Fund if the funds are not reimbursed from another source.

Former Vice President Biden has proposed increasing Social Security payments for low-income beneficiaries as well as increasing survivor’s benefits. To pay for this, he has proposed requiring workers earning $400,000 and above to pay increased payroll taxes. 

Medicaid
President Trump has argued in favor of repealing the Affordable Care Act (ACA), which expanded Medicaid to low-income adults in many states. His administration is currently supporting a lawsuit before the Supreme Court that will decide the law’s fate. He is also allowing states to fundamentally change their federal funding for Medicaid. Under the plan, states can ask for a waiver that would convert their Medicaid programs into a form of block grant and cap federal funding. States with block grant waivers could impose higher copays and cut benefits, such as denying coverage for prescription drugs, in order to contain costs. The coronavirus relief package, which the President signed into law, offers protections for Medicaid eligibility during the pandemic. 

Vice President Biden wants to retain and strengthen on the ACA, including Medicaid expansion. He also proposes increasing funding for home- and community-based services as an alternative to nursing home care and providing federal support for state Medicaid programs during the economic crisis brought on by the coronavirus pandemic. 

Medicare
President Trump supports repeal of the ACA, which has consequences for Medicare beneficiaries, including reduced services and possible increased costs. His FY2021 budget includes proposed cuts to Medicare spending. The President has also capped Medicare Part D insulin copays for some beneficiaries and expanded benefits that Medicare Advantage companies can offer their enrollees.  

Vice President Biden has proposed lowering the age of Medicare eligibility to 60. He also supports adding vision, hearing, and dental benefits to Medicare and lowering prescription drug costs by allowing the government to negotiate prices with drug companies. 

Long-Term Care
President Trump’s support for repeal of the ACA and federal caps on Medicaid spending could limit funding for long-term care. His FY2021 budget called for extensive cuts to Medicare and Medicaid, which primarily fund long-term care. He has also proposed loosening regulations on nursing homes, including infection control requirements.

In July, Vice President Biden unveiled a plan to lower the cost of caregiving.  The plan includes increased federal funding for Medicaid home- and community-based services along with tax credits for informal caregivers and increasing the wages of paid caregivers. He supports increasing the tax benefits for people who purchase long-term care insurance. Biden has also called for more oversight of nursing homes.