Trump v. Clinton: How They Line Up On Health

July 25--In a presidential campaign that has been much more about personality than policy, here's some news: A lot of Americans really do care about health care.

Terrorism and the personal attributes of Donald Trump and Hillary Clinton top a list of 10 issues that registered voters consider "extremely important" in a recent poll, but not far behind are gun policy, the economy and, at No. 5, health care. The Kaiser Tracking Poll found 37 percent of voters checked off this issue.

And the Trump vs. Clinton race offers voters a stark choice, starting with their views on the Affordable Care Act, also known as Obamacare. Clinton wants to improve it and make it more affordable. Trump has vowed to kill it, starting on the day he takes office.

Abortion? Clinton is decisively pro-choice; Trump, pro-life, a stance bolstered by his selection of Indiana Gov. Mike Pence, a champion of abortion restrictions, as his running mate.

Though the Kaiser poll, of 1,212 adults July 5 to 11, considered gun policy as a separate issue, many experts call gun violence a top public health crisis in the United States. Again, the two are poles apart.

We have pulled together an at-a-glance list summarizing their views on a range of health and science issues. It shows not only their differing opinions, but also their differing styles. Clinton is given to detailed policy positions; Trump, not so much.

But it also shows that there are a few similarities even between these two. For instance, neither wants to rile the many voters who care deeply about Medicare and Social Security.

And both know that paying for health care and prescription drugs is deeply important to Americans, though they disagree on how to tackle the problem.

Campaign trail decrees and promises aside, what will the victor be able to accomplish? What compromises will he or she be able to wring from Congress? What about times of crisis?

How will the leader lead?

For now, all voters can do is look for clues.

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HILLARY CLINTON'S POSITIONS

Health insurance

Clinton wants to improve the Affordable Care Act. She wants to reduce the cost of health insurance purchased on exchanges and provide a tax credit of up to $5,000 a family to offset out-of-pocket costs and premiums above 5 percent of household income. She would expand current tax credits and cap the cost of premiums at no more than 8.5 percent of family income. She also calls for fixing the "family glitch" so families can access coverage in the exchanges when their employer's family plan is unaffordable.

She would allow undocumented immigrants to buy insurance through the exchanges. In what is seen as a nod to Bernie Sanders' supporters, she is affirming support for a so-called public option that would allow people as young as 55 to buy health insurance through Medicare.

Prescription drugs

Clinton wants to eliminate tax breaks that pharmaceutical companies get for direct-to-consumer advertising, and require those that benefit from federal research spending to reinvest profits into research. She also would ban legal settlements in which pharma companies pay competitors so they will hold off on introducing generics and would allow consumers to reimport cheaper drugs from countries such as Canada. She supports allowing Medicare to negotiate lower drug prices and would cap out-of-pocket costs for people with chronic health problems.

Medicaid

Supports President Obama's proposal to let states that sign up for Medicaid expansion to receive a 100 percent match for the first three years. Would expand access to Medicaid and children's health insurance.

Medicare

Clinton has vowed to fight proposals to privatize or phase out Medicare, and she would give Medicare the power to negotiate lower drug costs.

Social Security

She opposes privatization, reducing annual cost-of-living adjustments, and raising the retirement age. She would expand Social Security for some, such as widows and caregivers, and help to fund the benefit through a wealth tax.

Veterans Administration

She says she would ensure more timely benefits, block privatization efforts, and strengthen services for military families and employment programs for veterans.

Abortion

"I believe we need to protect access to safe and legal abortion, not just in principle but in practice," Clinton said at a campaign rally in January in New Hampshire. "Any right that requires you to take extraordinary measures to access it is no right at all."

HIV/AIDS

Clinton's proposals include funding research to seek a cure; finding more affordable treatment, including capping prescription costs; urging all states to extend Medicaid coverage for people living with HIV; and increasing use of HIV prevention medication.

Medical research funding

Advocates increasing funding for Alzheimer's research to $2 billion a year, paying for care-planning services through Medicare, and funding a federal program to help locate Alzheimer's patients who wander.

Autism

Clinton has called for a nationwide early-screening campaign. She wants to push all states to require health insurance coverage for autism services, help get adults on the autism spectrum connected to employment opportunities, and fund more research.

Addiction and drugs

Would increase funds for addiction treatment and prevention, and emphasize rehabilitation over prison for low-level and nonviolent drug offenses. She wants more preventive services for adolescents, opioid antidotes for all first responders, and more training for drug prescribers.

She does not support federal legalization of recreational marijuana, but opposes imprisonment for those who use it and favors further study.

"I think that we have the opportunity through the states that are pursuing recreational marijuana to find out a lot more than we know today," she said at the Democratic debate in October.

Medical marijuana

"I do support the use of medical marijuana, and I think even there we need to do a lot more research so that we know exactly how we're going to help people for whom medical marijuana provides relief," she said in October.

Gun control

Clinton has spoken in favor of stronger gun control laws, including banning assault weapons, tightening background checks, and preventing people who are on federal no-fly lists for suspected terrorist ties from purchasing weapons.

She has spoken out against elected officials who have blocked legislation intended to curb gun violence. "We may have our disagreements about gun safety regulations but we should all be able to agree on a few things," Clinton said in Cleveland last month, shortly after the Orlando nightclub massacre. "If the FBI is watching you for a suspected terrorist link, you shouldn't be able to just buy a gun with no questions asked."

Family and medical leave

Clinton advocates a paid family and medical leave of up to 12 weeks with at least a two-thirds wage replacement rate (currently, such leave is unpaid). She proposes paying for the plan with taxes on the wealthy.

Federal funding of Planned Parenthood

"I'm proud to stand with Planned Parenthood. I'll never stop fighting to protect the ability and right of every woman in this country to make her own health decisions," Clinton said in a 2015 campaign video.

Energy

Clinton wants to make the United States "the world's clean energy superpower." She wants to reduce greenhouse gas emissions, cut methane emissions, spend $30 billion to revitalize coal communities, and expand energy efficiency in low-income communities.

She supports fracking with environmental controls when there is local support for the practice.

Climate change

"Climate change is real, it is being driven by human activity, and it is happening now," Clinton said in May.

She wants to launch a $60 billion "Clean Energy Challenge" for states and communities to go beyond federal standards to cut carbon pollution and expand clean energy. She advocates advancing renewable energy, cutting waste, and reducing American oil consumption by a third.

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DONALD TRUMP'S POSITIONS

Health insurance

Trump opposes requiring individuals, even those who can afford it, to buy health insurance. He wants to repeal the Affordable Care Act. He proposes to make coverage more affordable by allowing sales of health insurance across state lines and permitting people to deduct health insurance premium payments from their taxes. He would emphasize tax-deductible health savings accounts (HSAs), where funds could accumulate if they are not used. He wants to require price transparency by health-care providers so that individuals can shop around for the best prices. He also wants would-be immigrants to certify that they can pay for their own health care.

Prescription drugs

Trump calls for a free market for prescription drugs, including allowing consumers to import them from countries that regulate prices. This practice is now illegal, though the law is not firmly enforced.

Medicaid

He wants states to get their federal Medicaid funding through block grants, which could mean fewer dollars for many states, but would give local officials more authority over expenditures.

Medicare

After seeming to agree with his then-opponent Ben Carson about replacing Medicare with health savings accounts, Trump last October spoke on MSNBC against the proposal. "Abolishing Medicare, I don't think you'll get away with that one. It's actually a program that's worked. It's a program that some people love, actually," Trump said.

Social Security

Trump has voiced support for Social Security and called it "honoring a deal." He has said Republicans cannot win elections if they seek to change it substantially.

Veterans Administration

Trump has vowed to reform the agency and make it more efficient in delivering service and employment assistance. "We're going to transform the VA to meet the needs of the current veterans," he said in October during an appearance in front of the USS Wisconsin in Virginia.

Abortion

Back in 1999, he told Meet the Press that, despite his personal dislike of abortion, "I'm very pro-choice." More recently, he announced, "I am pro-life." This year, Trump he said on MSNBC that if abortion were banned, women who violated the law would have to be punished. Soon after, his campaign released a statement saying that providers, not patients, should be held liable. His running mate, Indiana Gov. Mike Pence, has backed some of the nation's toughest abortion restrictions.

HIV/AIDS

Trump has not issued a policy on HIV and AIDS, though some in the advocacy media say his goals of lowering prescription drug costs and increasing transparency about health care pricing could be beneficial.

Medical research funding

Trump has called funding for Alzheimer's research "a total top priority," but he has not offered many specifics about policies he would pursue. He also has alarmed the research community with scientifically unfounded statements about Ebola, autism, and climate change.

Autism

In tweets and during a presidential debate, Trump has linked autism to some vaccinations, a tie that has been widely debunked by international medical authorities and advocates such as Autism Speaks, a group that Trump has supported.

Addiction and drugs

In New Hampshire, Trump vowed to fight addiction on two fronts. "First, we have to support locally based and locally run clinics, and we have got to close the border. That's where the drugs are coming from."

At the Conservative Political Action Conference in June 2015, Trump was asked about Colorado's legalization of marijuana and responded: "I say it's bad. Medical marijuana is another thing, but I think it's bad, and I feel strongly about it." Shortly after he suggested leaving marijuana regulation to the states and studying the consequences of legalization in places such as Colorado.

Medical marijuana

"I think medical should happen -- right? Don't we agree? I think so," at a 2015 rally in Nevada.

Gun control

Gun control is another issue that has seen an evolved Donald Trump. In his 2000 book The America We Deserve, Trump calls for a ban on assault weapons. In his 2016 presidential race, he is a firm defender of Second Amendment rights. He has vowed not to push for banning assault weapons if elected. "People need protection," he said in a recent Today Show interview. If assault weapons were banned, he said, "the bad guys will have the assault rifles and the people trying to protect themselves will be standing there with a BB gun."

Family and medical leave

"Well, it's something that's being discussed," he told Stuart Varney on Fox News last year. "I think we have to keep our country very competitive, so you have tonbe careful of it."

Federal funding of Planned Parenthood

At a news conference on Super Tuesday, Trump said he would not give federal funds to Planned Parenthood because the organization performs abortions. But he praised the health care it provides, saying, "millions and millions of women -- cervical cancer, breast cancer -- are helped by Planned Parenthood."

Energy

Trump has promised to make the United States independent of any need to import energy from OPEC or "any nations hostile to our interests." His "100-day action plan" includes revoking regulations that hinder energy production, such as moratoriums on use of federal lands and restrictions on new drilling. He supports coal, and hydraulic fracturing (fracking) to extract natural gas, and says he also supports alternative energy sources.

Climate change

He wants to cancel the Paris Climate Agreement and halt U.S. payments to United Nations' global warming programs. As he tweeted in January: "Any and all weather events are used by the global warming hoaxsters to justify higher taxes to save our planet! They don't believe it $$!" At a March meeting with the editorial board of the Washington Post, he said: "I am not a great believer in man-made climate change."

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