Vice President Kamala Harris and former President Donald Trump have different stances on health care policy in America, although in the 2024 presidential election, health care has not played as prominent a role in the campaign as it did in 2016 or even in 2020. In those campaigns those on the left proposed a radical overhaul of Obamacare, while Republicans sought to repeal it.
Harris has backed away from single-payer health care
During her 2020 presidential campaign, Harris’ position on the future of private health insurance was sometimes confusing. In a primary debate in 2019, Harris raised her hand when moderators asked candidates if they would get rid of private health insurance. But then soon afterward, she said no, she would not eliminate private health insurance.
In April 2019, Harris co-sponsored Sen. Bernie Sanders’ “Medicare for All” bill, which would have ended private health insurance and replaced it with a single government-run insurer for all Americans.
Harris released a health care plan in 2019 that would have put the U.S. on a path to government-backed health insurance over 10 years but wouldn’t eliminate private health insurance.
“We will allow private insurers to offer Medicare plans as part of this system that adhere to strict Medicare requirements on costs and benefits,” Harris said at the time. “Medicare will set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around.”
Trump often brings up Harris’ past backing of “Medicare for All” on the campaign trail, accusing her of pledging to “force everyone onto socialist, government-run healthcare with high taxes and deadly wait times.”
Harris’ campaign says she will not push for single-payer government health insurance, should she become president.
“I absolutely support and over the last four years as vice president, private health care options, but what we need to do is maintain and grow the Affordable Care Act,” Harris said in her debate against Trump.
Trump says he has “concepts” of a health care plan
During the debate in Philadelphia, Trump said he’d “replace” Obamacare, which Republicans in Congress have largely given up on in recent years. Trump and a Republican Congress tried to “repeal and replace” Obamacare in 2017 and failed.
“Obamacare was lousy healthcare always was,” Trump said. “It’s not very good today. And what I said that if we come up with something and we are working on things, we’re going to do it and we’re going to replace it.”
One of the moderators asked for simple yes or no answer — does he still not have a health care plan?
“I have concepts of a plan,” Trump said. “I’m not president right now, but if we come up with something, I would only change it if we come up with something that’s better and less expensive. And there are concepts and options we have to do that, and you’ll be hearing about it in the not too distant future.”
At rallies, Harris has painted Trump’s attacks on the Affordable Care Act as endangering some of the law’s most popular provisions, like ensuring coverage for people with pre-existing conditions.
Trump has denied those claims. While president, he repeatedly vowed that GOP efforts to replace Obamacare on Capitol Hill would maintain protections for pre-existing conditions.
Trump struggled to come up with a health care plan while he was president, sometimes saying he would have a plan out in “two weeks.”
As president, Trump opposed Obamacare after its passage, tweeting calls for its repeal dozens of times, but the most promising attempt at repealing the law failed with the late Sen. John McCain’s dramatic thumbs-down vote in 2017.
Trump and Republicans have tried to repeal or weaken the Affordable Care Act in other ways, too. In December 2020, during the coronavirus pandemic, the Trump administration asked the Supreme Court to overturn Obamacare. Its filing came on the same day the government reported that close to half a million people who lost their health insurance amid the economic shutdown signed up for coverage through HealthCare.gov.
In the case, Texas and other GOP-led states argued that the ACA had in essence been rendered unconstitutional after Congress passed the 2017 Trump tax cut, which had eliminated the unpopular fines for not having health insurance but left in place its insurance coverage requirement. The Supreme Court rejected the challenge.
In 2018, the Trump administration temporarily suspended risk adjustment payments to insurers — money that’s used to fund insurers with sicker, higher-cost patients. In 2017, the Trump administration shortened the enrollment period and shut down the federal healthcare exchange for 12 hours nearly every Sunday.
Harris wants to continue Biden’s crackdown on pharmaceutical companies
Harris has called for broadening parts of the Inflation Reduction Act that target drug prices, in addition to “cracking down” on drug manufacturers and insurance “middlemen” that drive up costs.
Harris cast the tie-breaking vote in 2022 for the Inflation Reduction Act, which allows Medicare to negotiate drug prices for its more than 60 million members.
So far, the Biden administration has set caps for the price of a number of drugs for Medicare patients, including Eliquis for blood clots, Entresto for heart failure and insulin. Those will take effect in 2026.
Harris backs extending the law’s ceilings on insulin prices and out-of-pocket spending beyond Medicare, as some in Congress have proposed. Harris also wants to expand the negotiation program, allowing Medicare to set caps for more drugs at a faster pace.
Trump has also pledged to lower drug prices, though his campaign recently distanced itself from a proposal it had floated: reviving a controversial attempt to tie Medicare prices to other countries, which was rolled back in 2021 amid multiple legal challenges.
Trump says he wants to mandate IVF coverage, but Republicans in Congress aren’t so keen
Trump has said he wants either the government to fund in vitro-fertilization (IVF) or to mandate that private insurance companies pay for the expensive and intensive fertility procedure.
Infertility advocates have backed these kinds of proposals on Capitol Hill. One bill touted by a handful of House Republicans over the summer would have required private health insurance plans to cover the procedure.
But Republicans on Capitol Hill don’t all necessarily see eye to eye with Trump on mandating IVF coverage. IVF is an expensive procedure, costing between $12,000 and $24,000 per cycle. And many couples need multiple IVF cycles to have a baby, since only about 36% of cycles resulting in a live birth for women ages 35-37 using their own eggs. That percentage drops to 8% per cycle for women over 40 using their own eggs.
Senate Republicans have twice blocked legislation that would protect access to IVF and require insurance companies to cover fertility care, a vote Senate Democrats took to draw attention to Trump’s statements about fertility coverage. Only two Republicans — Sens. Susan Collins of Maine and Lisa Murkowski of Alaska — voted with Democrats in favor of the legislation.
“If Donald Trump and Republicans want to protect people’s right to access IVF, they can vote yes on it,” Sen. Tammy Duckworth of Illinois, who sponsored the legislation, told CBS News ahead of the vote. “He’s shown that it only takes one sentence from him, and the Republican Party will fall in line behind him.”
Senate Republicans have repeatedly expressed support for IVF, while claiming Democrats’ legislation goes too far. Sens. Ted Cruz of Texas and Katie Britt of Alabama introduced their own package to protect access to IVF this year, but Democrats rejected it, questioning its scope and enforcement measures.
Other Republicans, like former Gov. Nikki Haley, have said access to IVF is a good thing, but coverage shouldn’t be mandated.
“Both of my children were products of fertility [treatments],” she told CBS News‘ “Face the Nation.” “We want that option to be available to everyone. But the way you do it is you don’t mandate coverage. Instead, you go and you make sure that coverage is accessible, and you make sure that you’re doing everything you can to make it affordable.”
More than a dozen states and Washington, D.C., already mandate that some private insurance plans cover IVF.