Few issues have divided Republicans and Democrats more than healthcare over the past decade, and so have President Trump and former Vice President Joe Biden.

The two men offer completely different ideas about what the federal government should do to ensure Americans have access to affordable medical care.

They differ in terms of the Affordable Care Act of 2010, often referred to as Obamacare, and the protection that health insurers should need to provide to consumers. They have opposing visions of Medicare and Medicaid, the state health plans for the elderly and poor.

Trump and Biden have outlined different strategies for lowering prescription drug prices. They take opposing approaches to reproductive health policies and abortion rights.

And they have adopted different visions of public health and the fight against the coronavirus pandemic.

Here's a look at what the two healthcare candidates are proposing:

Joe Biden, unlike President Trump, is an outspoken advocate of wearing a mask to prevent the spread of COVID-19.

(Associated Press)

Joe Biden

During the Democratic primary, Biden differs from many of his rivals by rejecting calls to include all Americans on a single state health plan: "Medicare for All."

Biden, who as Vice President was a strong supporter of President Obama's drive to pass the Affordable Care Bill, argued that expanding the 2010 bill and maintaining a mix of government plans and employer-based insurance would be more practical, cheaper, and less disruptive.

But he has called for a public option, a Medicare-like plan that would be available to Americans who can't afford commercial insurance or who live in a state that hasn't upgraded Medicaid eligibility.

Biden advocates increasing subsidies to help Americans buy plans in insurance markets created by the 2010 law.

He has announced that he would take back Trump administration policies that relaxed the rules for health insurers and would allow some to offer limited insurance policies that cap benefits and exclude coverage for some illnesses and pre-existing conditions.

Biden has come up with a long list of drug price control proposals, including giving Medicare the power to negotiate with drug manufacturers. This has been a long-standing priority for Democrats that many experts believe would save money for the federal government.

He would also set up a panel that could assess the value of new drugs and recommend a price, a model that has been effective in capping prices in other wealthy countries like Germany.

Like most Democrats, Biden was a strong advocate of abortion rights, and he would likely lift many of the restrictions imposed by the Trump administration.

Regarding the novel coronavirus, Biden has repeatedly stated that he will prioritize the advice of public health experts and let them advance the national response to the pandemic.

Unlike Trump, Biden has been a proponent of the wider use of face masks to reduce the spread of infection. This position is widely supported by epidemiologists, public health officials, and other experts.

In his speech in Wilmington, Delaware, introducing Senator Kamala Harris as his ally, he promised that his administration would come up with "a comprehensive plan to meet the challenge of COVID-19 and fight this pandemic."

Elements he cited included “masking; clear, science-based instructions; Extend testing dramatically ”and“ Provide states and municipalities with the resources they need to keep schools and businesses open safely. "

He also said that "scientists and public health experts should decide the safety and effectiveness of a vaccine". "The White House should not weigh these matters or press the FDA to issue emergency clearances ahead of time," he said in a statement in late July.

The Biden campaign posted its health plan on their website.

President Trump takes a tour of Owens & Minor Inc., a medical utility company in Allentown, Pennsylvania.

President Trump visits Owens & Minor Inc. in Allentown, Pennsylvania in May. The medical supply company manufactured personal protective equipment during the pandemic.

(Associated Press)

President Trump

Trump has provided little detail on what his health agenda would look like in a second term.

Despite years of promises to replace the Affordable Care Act, Trump has not offered a plan. Unlike most campaigns in the past two decades, his campaign website does not include a list of healthcare priorities.

A spokesman for the campaign declined to learn details of Trump's health platform, saying only the president would "continue to prioritize the health and welfare of the American people while undoing the damage caused by the previous administration".

Even so, Trump did provide clues about his health care priorities in his first term.

He remains a passionate supporter of the 2010 health bill repeal, an effort he supported in his first year in office when Republicans pushed it in Congress. His administration is currently calling on the Supreme Court to repeal the entire law and it has repeatedly called for its provisions in its annual budgets to be repealed.

The Trump administration has enacted regulations that allow health insurers to bypass consumer protection mandates in health law, which require health insurance plans to cover a range of essential benefits. This move has led to the proliferation of short-term plans that are sometimes cheaper for qualified people – mostly young and healthy – but offer scarcer coverage.

The president has also consistently supported major cuts in federal health programs, including Medicaid. His government has proposed hundreds of billions of dollars for Medicaid cuts and tighter restrictions on coverage because the benefits currently on offer are too costly to taxpayers and discourage people from looking for work.

During his first term in office, Trump made repeated promises to cut drug prices, a promise he also made during his 2016 campaign.

With many of his drug price initiatives still unfulfilled, the president recently instructed his government to simplify the import of cheaper drugs from other countries and to limit the discounts that middlemen, known as Pharmacy Benefit Managers, can get when discussing prices with drug manufacturers negotiate on behalf of health insurers. These new efforts would only take effect long after the election.

In his 2016 campaign, Trump backed Medicare's permission to negotiate drug prices. Once in office, however, he dropped the idea, which was vehemently opposed by drug makers and Republican lawmakers.

The Trump administration has strongly endorsed initiatives to restrict access to abortion, block funding for Planned Parenthood and overseas aid groups that advise women on abortion, and repeal the rules that mandate contraceptive health plans for women. These efforts would likely continue into Trump's second term.

In the case of the corona virus, it is unclear what the president would do differently if he were re-elected. He continued to call for schools, sports leagues and companies to reopen, saying repeatedly that he expected the virus to "go away" at some point.

His administration has poured billions of dollars into efforts to expedite development of a vaccine that Trump sometimes said could be approved for use before the November election.

Despite the huge death toll from the disease in the US, the Trump campaign cites the president's work on the pandemic as one of the major achievements of his first term and characterizes it as a "courageous, aggressive and determined response."

While there is no health plan on the Trump campaign website, it does list what the campaign sees as its health benefits.

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