The Evolving Health Care Stances of Donald Trump and Kamala Harris: A Fork in the Road
As the 2024 presidential election approaches, the health care policies of former President Donald Trump and Vice President Kamala Harris have come under scrutiny. Both candidates have shifted their positions over the years, proposing more measured reforms compared to their past stances. However, experts warn that the stakes are high in this election, with the future of health care hanging in the balance. Larry Levitt, executive vice president for health policy at KFF, aptly describes the situation as “a bit of a fork in the road for the future of health care.”
Trump’s Health Care Evolution
During the recent ABC News Presidential Debate, Trump was pressed for specifics regarding his health care plan. His response was somewhat vague: “I have concepts of a plan. I’m not president right now.” This statement reflects a significant shift from his previous administration, where he championed efforts to repeal the Affordable Care Act (ACA), commonly known as “Obamacare,” without presenting a concrete replacement plan. At one point, he infamously declared, “let Obamacare implode,” indicating a hands-off approach to a system that he believed was failing.
Now, Trump claims he would adopt a different approach if re-elected. “If we can come up with a plan that will cost our people, our population, less money and be better healthcare than Obamacare, then I would absolutely do it,” he stated. Until then, he suggested he would manage the existing system as effectively as possible. This marks a notable pivot from his earlier, more aggressive stance against the ACA.
Harris’s Shift from Medicare for All
Vice President Kamala Harris has also seen a transformation in her health care position. Previously, as a U.S. Senator, she co-sponsored “Medicare for All” legislation aimed at eliminating private health insurance in favor of a government-run system. However, during the debate, Harris emphasized her support for maintaining and growing the ACA, stating, “I absolutely support private health care options.”
Experts highlight the importance of the ACA, which has protected patients with pre-existing conditions and made health insurance more affordable through financial assistance. Under the Biden-Harris administration, temporary subsidies were introduced during the pandemic and later extended through the Inflation Reduction Act. These measures increased aid for those already eligible under the ACA and expanded subsidies to middle-income individuals.
The Future of the Affordable Care Act
Levitt notes that while it is unlikely that either candidate will attempt to repeal the ACA again, a significant debate looms over whether to continue the enhanced premium subsidies established during the Biden-Harris administration. These subsidies have saved ACA enrollees an average of $700 a year and contributed to record enrollment. However, they also represent a substantial cost to the federal government, and their future is uncertain as they are set to expire at the end of 2025.
The Democratic platform advocates for making health insurance premium tax credits permanent, while Republicans have historically sought to eliminate such subsidies. The Republican platform outlines broad health care goals, emphasizing transparency, choice, competition, and expanding access to affordable health care and prescription drug options.
Prescription Drug Policies: A Point of Contention
During the 2023 Republican primary, Trump pledged to sign an executive order on his first day in office to “end global freeloading on American consumers once and for all.” He proposed a policy where the U.S. government would negotiate drug prices with pharmaceutical companies, ensuring that Americans pay no more than the best price offered to foreign nations. However, the Trump campaign has not provided detailed information regarding his prescription drug policies or whether he would seek to repeal reforms made under the Biden-Harris administration.
In contrast, Vice President Harris played a pivotal role in passing legislation that requires Medicare to negotiate the cost of certain medications with pharmaceutical companies. This law also capped the cost of insulin and out-of-pocket drug spending for seniors on Medicare. Harris has expressed a desire to expand these reforms to all Americans, but she may encounter resistance in Congress.
Conclusion
As the election approaches, the health care policies of Donald Trump and Kamala Harris reflect their evolving stances and the broader political landscape. With significant implications for millions of Americans, the debate over health care reform is poised to be a central issue in the upcoming election. As both candidates navigate their positions, voters will be keenly watching to see how these policies will shape the future of health care in the United States.
