The Buzz This Week
Last week President Biden shared that he would not be seeking a second term and endorsed Vice President Harris to top the Democratic ticket. While Harris has not officially secured the nomination, the majority of delegates have pledged their support, and she faces no other challengers.
Harris is likely to make healthcare a focus of her campaign and have a similar stance to Biden on most healthcare issues. Many expect her to tout the Biden-Harris health policy accomplishments from the last four years. Those include capping the cost of insulin for Medicare beneficiaries at $35 a month, eliminating medical debt from credit reports, and setting minimum staffing requirements at federally funded nursing homes, among others.
Meanwhile, former President Trump and the GOP have given limited attention to healthcare issues in recent speeches and at the Republican National Convention earlier this month. Yet we may see more discussion of healthcare as the election unfolds, potentially through the vice presidential candidate. During Trump’s first term in office, Vice President Mike Pence had a significant influence on the administration’s healthcare policy.
Earlier this month, Trump selected Ohio Senator J.D. Vance as his running mate. Vance is a venture capitalist with a background of investing in biotech and digital health startups. He has introduced health legislation in Congress and been outspoken on several healthcare issues and will likely help to shape the GOP’s healthcare policy, should Trump be elected.
Why It Matters
With Harris the presumptive Democratic nominee and Vance joining the GOP ticket, how might they influence their respective parties? Below we highlight some key areas of healthcare policy and what may be expected under each administration.
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Women’s health: Trump has taken credit for and Vance applauded the overturning of Roe v. Wade. Vance has a stronger stance on abortion than Trump and has supported abortion bans with no exceptions. He has also noted that he would vote for a nationwide abortion ban at 15 weeks. Vance has also previously stated a desire to ban in vitro fertilization (IVF) but has downplayed this topic in recent weeks.
One key area where Harris differs from Biden is that she is expected to be more vocal on reproductive rights. She supports codifying abortion access into law. She also supports broad access to contraception, fertility treatments like IVF, and improvements to women’s health to address maternal mortality. These include diversifying the maternal health workforce, extending Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage for 12 months after pregnancy, and funding for community-based organizations. Though her platform is still developing, reproductive freedom and affordable healthcare likely will be a cornerstone. Both are noted in her first campaign advertisement.
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Artificial intelligence (AI) in healthcare: The Biden Administration has noted the profound good AI can do but also highlighted concerns about unsafe and unregulated use in healthcare. Biden signed an executive order establishing the first standards for AI in healthcare.
Trump has said he would repeal the executive order. His administration would likely be more lenient on regulations in AI.
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Antitrust: Harris has historically been tough on healthcare antitrust deals. As California Attorney General, she made arguments against a mega-merger between Anthem and Cigna. But she has not yet signaled a point of view on changes from the Biden Administration.
Vance, in a break from his party, has previously praised Biden’s head of the Federal Trade Commission Lina Khan, so significant policy shifts are unlikely, regardless of who is elected in November.
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LGBTQIA+ health: Vance has been outspoken in his goal of banning taxpayer coverage of gender-affirming care and any gender-affirming care for minors. He introduced legislation to the US Senate that would make providing gender-affirming care to minors a felony with a minimum 10-year prison sentence.
Harris has repeatedly spoken against bans on gender-affirming care. The Biden Administration also updated the nondiscrimination clause of the Affordable Care Act (ACA), reaffirming that discrimination based on sex includes sexual orientation and gender identity and restoring protections removed during the Trump Administration.
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Medicare and Medicaid programs: The potential administrations have some agreement and some dissent on changes desired to the Medicare and Medicaid programs. Both Harris and Vance support negotiating drug prices for Medicare. Many in the GOP disagree with this position, arguing it could hurt new drug development.
The Biden Administration finalized a rule expanding government-subsidized health insurance to Deferred Action for Childhood Arrival participants, or “Dreamers.” Vance introduced a bill to deny access to health insurance through Medicare and Medicaid for that group.
The Biden Administration has been vocal on the need for oversight of Medicare Advantage (MA) plans, introducing significant regulations in the Centers for Medicare & Medicaid Services final rules in recent years and creating complexity in MA plan administration. Trump’s last administration and Republican administrations historically have placed fewer direct controls on MA in favor of private market dynamics driving the platform. However, Vance has argued that when it comes to healthcare, the government must play a role in oversight and regulation and that a hands-off approach will not fix the system.
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Affordable Care Act: A key Biden-Harris accomplishment was enhanced ACA tax credits to purchase insurance. Harris will likely continue to focus on policies like this that make healthcare affordable and accessible.
Trump tried to repeal the ACA in his first term but has since pivoted to say he will improve the ACA, not sharing specifics as to what aspects he would change. Vance did not support the repeal of the ACA but has noted he would support reform to make healthcare more affordable. Neither Trump nor Vance have commented on whether they would support the extension of enhanced ACA subsidies.
This is not a comprehensive list of healthcare issues that the presidential election results may impact. In the coming months, the candidates are likely to share perspectives on other important topics, including the opioid crisis, healthcare investing, public health, and the impact of climate change and environmental hazards on health. State and local elections, as well as administrative and judicial appointments, will also greatly influence health policy in the coming years.
Additionally, both potential administrations are still developing and evolving their platforms. Harris is expected to announce in the upcoming week her vice-presidential choice, who may impact her platform. Both administrations have already voiced potential shifts in position from historical statements. While campaign speeches and previous legislative support are indications of where each administration may stand, neither are a guarantee of future policy action.
RELATED LINKS
Kaiser Health News:
Harris, Once Biden’s Voice on Abortion, Would Take an Outspoken Approach to Health
The Hill:
JD Vance’s views on health care: What to know
Kaiser Family Foundation:
The Role of Health Care in the New Presidential Election
Stat News:
Kamala Harris, endorsed by Biden to replace him, is left of the president on health care
Editorial advisor: Roger Ray, MD, Chief Physician Executive.
