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Oct. 30, 2020, 4:14 p.m. EDT

Here’s where Trump and Biden stand on COVID-19, other health-care issues

President and Democratic nominee are both being pulled by a wing of their party on the issue of medical coverage, analyst says

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By Victor Reklaitis, MarketWatch

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Related: Trump lashes out amid pandemic at medical research that’s discordant with his views

And see: How Congress is spending trillions in response to the coronavirus crisis — in one chart

About $5 trillion has been spent or committed in response to the pandemic and economic crisis, according to a COVID Money Tracker run by the bipartisan Committee for a Responsible Federal Budget, an anti-deficit group.

The CRFB estimates that Trump has proposed between $530 billion and $870 billion in additional spending and tax relief to address the current public health and economic crisis, while Biden has backed between $2.0 trillion and $4.2 trillion in additional measures. Those estimates don’t include the $1.8 trillion to $1.9 trillion stimulus offer made by the Trump administration to House Democrats, and they don’t include the $3 trillion aid bill passed by the Democratic-run House and supported by Biden.

Medical coverage

Biden is promising to build on Obamacare, meaning the Affordable Care Act that overhauled the U.S. health-care system /zigman2/quotes/205918244/composite XLV -0.37%  a decade ago, when the longtime politician was President Barack Obama’s vice president.

The Trump administration is waging a legal fight against Obamacare, arguing that it must be scrapped after federal lawmakers in 2017 zeroed out the individual mandate’s penalty for lacking health insurance. That comes after the failure of Trump and the GOP’s efforts to repeal Obamacare, with the late Republican Sen. John McCain of Arizona casting a decisive vote at one point in 2017.

Biden and Trump are both being pulled by a wing of their party on medical coverage, said Capital Alpha’s Monk.

Progressive Democrats got Biden to “do a proposal that I think for them is a foothold in the door for a more expansive agenda that gets them closer to ‘Medicare for All,’” she told MarketWatch.

Biden is pledging to deliver a public-health insurance option, while “Medicare for All” (which was backed by many of his unsuccessful opponents in the Democratic presidential primary) would be a government-run program that replaces the private health insurance system. He also says he’ll lower the Medicare eligibility age to 60 from 65.

“While the perceived threat of a broad government-run ‘public option’ would threaten managed-care companies and hospitals, we believe the actual result will be something both managed care and hospitals /zigman2/quotes/208016503/composite IHF -2.14%  can live with,” Raymond James analysts said in a recent note.

Meanwhile, Trump “has been convinced by the right wing of the party that if they can somehow undo Obamacare, they can sweep in with more market-based reforms, while still protecting pre-existing conditions,” Capital Alpha’s Monk said. But there is no clear GOP consensus on an Obamacare replacement, and Trump’s recent executive order intended to protect those with pre-existing conditions does nothing legally and just proves he’s “feeling some pressure,” she added.

Trump signed the executive order in September in an effort to address the concerns of Americans with such conditions who have health-insurance protections because of Obamacare and fear those safeguards will disappear. That came as he announced an “America First Healthcare Plan” and $200 discount cards for Medicare recipients in a speech that conflated some of his administration’s achievements with policies that are in stages of implementation and others that remain aspirational.

Drug prices, surprise billing

Both Biden and Trump have made pledges to tackle rising prices for prescription drugs. And they’ve addressed surprise billing, the high fees charged after a procedure due to discrepancies in insurance coverage and other issues.

The president has talked up his recent executive orders on drug pricing, though analysts have dismissed them as “largely campaign fodder as each contains limitations or caveats, and is subject to further action.”

Drug pricing “definitely is a priority for both parties,” Monk said. Biden is likely to be pushed to do something that looks like the drug-pricing bill that passed the Democratic-run House last year, but the measure wouldn’t be able to pass even a Democratic-controlled Senate due to opposition from moderate Democrats, she predicted. Some analysts have described the bill as “nuclear winter” for drug makers /zigman2/quotes/200345932/composite PJP -1.59% .

To address surprise billing, a president “can’t do it with an executive order, or even with a regulation,” Monk said. “It’s going to require Congress to act to do it significantly.”

Related: Democrats’ chances of Senate takeover rise, and that could affect health care, energy and financial services

And see: Don’t buy health-care stocks if Democrats sweep the November elections, these contrarian analysts say

This is an updated version of a report first published on Sept. 28, 2020.

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Victor Reklaitis is MarketWatch's Money & Politics reporter and is based in Washington, D.C. Follow him on Twitter @VicRek.

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