The Health Care Showdown: Kamala Harris vs. Donald Trump in the 2024 Election

As the 2024 presidential election approaches its climax, the stakes for American health care have never been higher. With millions of lives hanging in the balance, the policies proposed by the candidates could shape the future of health care in the United States for years to come. Vice President Kamala Harris and former President Donald Trump present starkly different visions for health care, particularly in areas like drug pricing, the Affordable Care Act, and reproductive health. This article delves into their positions on these critical issues, highlighting the implications for Americans.

1. The Future of Medicare’s Drug Price Negotiations

One of the most significant achievements of the Biden-Harris administration has been the introduction of Medicare’s ability to negotiate drug prices directly. This landmark policy is set to take effect in 2026, with estimates suggesting that it could save patients and Medicare a staggering $7.5 billion. However, this authority is under threat, as many congressional Republicans, including Trump, have expressed intentions to repeal it, arguing that it could stifle innovation in drug development.

While Trump has not explicitly stated whether he would support repealing the law, health policy experts warn that the new negotiation powers remain vulnerable. Stacie Dusetzina, a health policy professor at Vanderbilt University, notes that the delayed implementation of these negotiations means that if they were to be repealed, many might not even notice the loss.

In contrast, Harris has committed to accelerating the negotiation process, aiming to lower drug prices more swiftly. Her campaign suggests that any savings from these negotiations would be reinvested into expanding Medicare coverage for home health care. However, experts caution that the actual financial benefits of such expansions may be minimal, raising questions about the feasibility of her proposals.

2. Extending the Affordable Care Act’s Enhanced Subsidies

The Affordable Care Act (ACA) has been a cornerstone of health care coverage for millions of Americans. In 2021, Congress removed the income cap for subsidies, significantly increasing the number of people who could afford health insurance. This change has led to a near doubling of ACA enrollment, with over 21 million people now covered. However, these enhanced subsidies are set to expire at the end of 2025, potentially doubling premiums for many and leaving millions without coverage.

Harris has made it clear that she supports making these enhanced subsidies permanent, a move that would cost the federal government an estimated $335 billion over the next decade. Conversely, Trump has not publicly committed to a position on this issue. Many Republicans, including former Trump officials, argue against extending the subsidies, citing concerns over potential fraud and misuse of the system.

The debate over these subsidies is further complicated by reports of enrollment fraud, with some estimates suggesting that up to 5 million people may have misstated their incomes to qualify for $0-premium plans. While some argue that this represents a significant issue, others contend that income variability in low-wage jobs makes accurate forecasting difficult.

3. The Future of Medication Abortion

The landscape of reproductive health care in the U.S. is also a critical issue in the 2024 election. Medication abortions, which account for nearly two-thirds of all abortions, are primarily facilitated by the drug mifepristone. Under the Biden-Harris administration, the FDA has expanded access to this medication, allowing for telehealth prescriptions, which have become increasingly common.

Harris has positioned herself as a staunch advocate for protecting and expanding access to abortion services, making it a key part of her campaign. In contrast, Trump’s stance on medication abortion has been inconsistent. While he has occasionally indicated that he would not restrict access, he has also suggested openness to federal restrictions. The conservative Project 2025 blueprint, associated with Trump, even calls for the FDA to withdraw its approval of mifepristone.

If Trump were to restrict access to mifepristone, it could lead to a shift in how medication abortions are administered, as women could still use misoprostol alone, albeit with potentially more side effects.

The Uncertainty of Trump’s Health Policy

While Harris’s positions on these three critical health care issues are clear and consistent, Trump’s health policy remains shrouded in uncertainty. His previous proposals, such as the "most favored nation" policy aimed at lowering drug prices, have been abandoned, leaving many to speculate about his future plans.

Health policy experts note that Trump’s rhetoric often lacks specificity, making it challenging to predict his administration’s approach to health care should he win a second term. This ambiguity raises concerns among voters who prioritize health care in their electoral decisions.

Conclusion

As the 2024 election draws near, the contrasting visions of Kamala Harris and Donald Trump on health care issues will undoubtedly shape the future of American health policy. With critical decisions regarding Medicare drug pricing, the Affordable Care Act, and reproductive health on the table, voters must consider the implications of each candidate’s proposals. The outcome of this election could determine the direction of health care for millions of Americans, making it imperative for voters to engage with these issues as they head to the polls.