If one watched Tuesday’s presidential debate on ABC News, one might be pardoned for thinking that Trump and Harris could not be more different when it comes to healthcare policy. Trump stripped women of federal protections as it relates to the Supreme Court decision on abortion and wants the states to chart their own individual paths. Harris wants to resurrect Roe’s federal protections so that women of different states have equal footing when it comes to issues surrounding their pregnancy and the decision to end it.
Aside from that, they are also on opposing sides on the Affordable Care Act though Trump appears to be resigned to the fact that it is now a popular policy among most Americans — when asked how he would repeal the ACA and improve it, he said he had “concepts of a plan.” Broadly, the differences center on the fact that Trump has generally been in favor of “deregulating health insurance and rolling back public programs,” while Harris would likely continue with “increased federal spending on healthcare,” said Cynthia Cox, vice president and director of the Program on the ACA at KFF, a nonprofit health policy research and news organization.
However, believe it or not, there are some areas where Harris and Trump have similarities and for those, you have to glance in the past. For instance, combating healthcare costs through price transparency.
“We’ve seen so much less in the way of formal policy platforms on either side,” said Rachel Nuzum, senior vice president for Federal and State Health Policy at the Commonwealth Fund. “And part of that is because we, in essence, have two incumbents. … Because we don’t have those extensive policy platforms that we’ve had in the past, we really do have to kind of look at their history, their record and obviously, some of their comments.”
Healthcare costs
One point of similarity between the two candidates vying for the top job is combating healthcare costs through price transparency.
During his presidency, Trump signed the No Surprises Act, which protects patients from unexpected medical bills when they receive out-of-network care. The Biden-Harris Administration began implementing the No Surprises Act in 2021, and proposed expanding the protections to ground ambulance providers.
The Trump administration also released a price transparency rule that mandated hospitals to post negotiated prices for their services. However, there were challenges in implementing the price transparency changes because there wasn’t a lot of standardization, so the Biden-Harris administration expanded on the rule, according to Cox.
“The Biden administration came in and actually kind of continued in the same direction as the Trump administration, and built on what the Trump administration had started,” she said. “They created more standardization to improve implementation of this rule. … I think a lot of Biden’s health policy was a direct response to what Trump had done, to undo things that Trump had done. [But] this is an example where they actually built on what Trump had started.”
Trump and Harris also seem to have an interest in addressing anti-competitive actions, like healthcare mergers, Nuzum said.
“Both camps potentially are interested in having a better understanding of what’s going on behind some of these mergers [and] the role of private equity in the healthcare sector,” she said. “I think there’s a lot of common ground there that we need more information, we want more transparency.”
Prescription drug prices
A major part of healthcare costs is expensive drugs. This is an area that gets a lot of bipartisan attention, though strategies have been slightly different. For example, Trump created a model that allowed Medicare Part D plans to voluntarily cap monthly insulin prices at $35.
Instead of making this voluntary, the Biden-Harris administration passed the Inflation Reduction Act, which mandates that all Part D plans charge no more than $35 per month for covered insulin products. Additionally, it sets a $35 monthly limit on cost sharing for insulin covered under Part B.
The Inflation Reduction Act also allows Medicare to negotiate with drug companies on the prices of certain Medicare Part B and Part D drugs, starting with 10 drugs. It’s unclear, however, where Trump stands on this since the program is in its early days, according to Nuzum.
“We know that policy change takes time. It hasn’t shown up at the pharmacy counter yet for patients, and so I am worried that that one could get sort of weighed down in administrative change, bureaucracy. … Once people have something, it’s hard to take it away,” she said. “And I don’t think most people realize that they have lower prices on Medicare yet on the set of 10, because we haven’t gotten to that point in the timeline yet.”
Another healthcare expert said that while the two seem to have a “shared interest” in addressing drug costs, the IRA seems to be where their paths diverge. While Harris would likely expand the negotiation program, Trump likely wouldn’t do this, according to Adam Searing, an associate professor of the practice at the Georgetown University McCourt School of Public Policy’s Center for Children and Families. Trump’s efforts were more focused on trying to import drugs from other countries, like Canada, at the lower prices those countries pay. Searing added that as far as he can tell, pharmaceutical companies aren’t thrilled by either candidate’s strategy.
In Vitro Fertilization (IVF)
Both candidates have said that they support access to IVF treatment, and Trump called himself a “leader” in this space during the debate, though this may conflict with his party’s platform. According to KFF, Trump would require the government or insurance companies to cover IVF, while Harris “supports guaranteed rights to IVF.” She also came out against the Alabama Supreme Court decision that ruled that embryos created during IVF should be considered children.
How these healthcare policies will shake out remains to be seen — after all, all politicians pivot from stated positions when they are actually elected. However, if one were to paint with broad strokes, Harris’ healthcare strategy seems focused on expanding access to care, while Trump’s policies are largely centered around reducing government involvement.
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