Philadelphia, Pennsylvania – September 10: Republican presidential candidate and former President Donald Trump … [+]
The heated presidential debate between Donald Trump and Kamala Harris was probably worth watching, but as is historically the case when presidential candidates go head-to-head, there wasn’t much substantive policy discussion. That said, when it came to health care, Harris reiterated her positions on Obamacare, anti-inflation legislation and abortion, while Trump was unwilling to commit to any specific policy.
Health care is the third-highest priority issue for voters, behind inflation and the need for bipartisanship, according to a May 2024 poll of voters by the Pew Research Center. Survey respondents cited rising health care costs as the top priority, with 57% saying that rising health care costs are a “very big problem” for the country today.
But it took more than 90 minutes into the debate before the moderator finally asked a question about health care.
Harris defended the Affordable Care Act and the Control of Inflation Act, noting that the ACA has been “strengthened” under Biden and that newly enacted IRAs “have lowered drug prices for seniors and capped insulin and other out-of-pocket costs.” [outpatient] Drugs.”
This week, the ACA reached a milestone of nearly 50 million people receiving insurance coverage under the act.
The $35 per month insulin copayment cap she mentioned is already in place and applies to all Medicare beneficiaries. The Trump administration issued an executive order in 2020 that limited insulin copayments to $35 per month under the voluntary model for a relatively small number of Medicare beneficiaries. In contrast, IRAs mandate such copayment caps for all Medicare beneficiaries.
The $2,000 annual cap on outpatient drug out-of-pocket costs mentioned by Harris will take effect in 2025. This means that Medicare beneficiaries will not pay more than $2,000 out-of-pocket for outpatient drugs in any given year.
Harris defended the Biden administration’s policies on prescription drugs and the ACA, reiterating a Democratic platform that “health care is a right, not a privilege.”
Trump made it clear that he did not have a specific proposal to replace the ACA, but said he had “a plan in mind.” This may have reminded viewers of similar comments he made about an ACA replacement while he was president. During his time in office, Trump frequently declared that he would come up with an alternative to the ACA. However, he never did so during his time in office.
During the debate, Trump asserted that “we can do much better than Obamacare,” but said he would only change it “if we come up with something that’s better and cheaper.” He also repeated points he has made in the past about “saving” the ACA during his presidency. Indeed, after failed attempts to repeal the ACA, the Trump administration issued multiple executive orders to “improve ACA market performance.” But overall enrollment in the program declined between 2017 and 2020. A Brookings Institution article details ways the Trump administration may have weakened the ACA rather than saved it.
Surprisingly, Trump did not dodge Harris’s point about lowering Medicare drug prices. He could have pointed out that the Trump administration had drafted a proposal to lower Medicare drug prices. As president, Trump issued an executive order to implement a “most favored nation” drug pricing policy for the Medicare program. Specifically, the most favored nation policy would require pharmaceutical companies to sell certain drugs to Medicare at the lowest price they offer to comparable countries abroad. Notably, however, the use of international price references was staunchly opposed by many Republicans in Congress, and the most favored nation policy was never implemented.
The two candidates expressed widely differing views on abortion rights, an issue that remains important to about 1 in 8 voters. According to KFF, 12% of voters said abortion is the most important issue they will consider when voting in the 2024 election.
President Trump has been ambiguous, saying he would not sign a nationwide abortion ban but not explicitly saying he would veto such a ban. He also claimed there was widespread support for the Supreme Court to overturn Roe v. Wade, but state polls and opinion polls show otherwise: more than 60% of Americans dislike the Supreme Court’s decisions.
Harris reiterated her strong support for women’s reproductive rights and criticized Trump’s role in helping to narrow abortion access in a growing number of states, but declined to say whether she would support restricting later-stage abortions.
