Health care is a defining issue in the 2024 election – Democratic presidential nominee Kamala Harris and Republican contender Donald Trump have starkly different records on the issue. Rather than focusing on what they promise to do, let’s examine what their past actions reveal about their approaches to Medicare, the , public health infrastructure, drug policy and child abuse and domestic violence prevention.
Author
Zachary W. Schulz
Lecturer of History, Auburn University
As a , I have carefully examined both candidates’ records on American health care. With years of experience in the health care field and being a cystic fibrosis patient myself, I have developed a deep understanding of our health care system and the political dynamics that shape it.
For me, as for many other Americans, health care is more than just a political issue; it is a deeply personal one.
Medicare
During Harris’ time in the Senate, she co-sponsored the , which aimed to expand Medicare to all Americans, effectively eliminating private insurance.
At the presidential debate on Sept. 10, 2024, Harris clarified her former support of “Medicare for All” by emphasizing her prior for patients’ rights and access to affordable health care.
Harris’s legislative efforts, primarily around the 2017-2020 period, reflect a commitment to broadening access to Medicare and reducing costs for seniors. During that time, Harris advocated for the Medicare program to negotiate drug prices directly with pharmaceutical companies.
Later, as vice president, Harris cast a , allowing the government to negotiate drug prices for Medicare with pharmaceutical companies.
In contrast, during Trump’s presidency, he made several attempts, some of which were successful, to . The 2020 budget proposed by his administration over 10 years, primarily by reducing payments to providers and slowing the growth of the program.
The proposed cuts did not take effect because they required Congressional approval, which was not granted. The plan faced significant opposition due to concerns about .
Affordable Care Act
Harris has been a staunch defender of the , also known as the ACA or “Obamacare.” As a senator, Harris consistently . She advocated for expanding its provisions, including supporting legislation that aimed to and .
Harris’ record shows a under the ACA. And, in the recent debate, to the act.
During his presidency, to , , which would have significantly reduced the scope of Medicaid expansion and removed .
Although these efforts ultimately failed in the Senate, Trump succeeded in weakening the ACA by through the . In the debate against Harris, Trump that the Affordable Care Act “was lousy health care,” though he did not ultimately offer a replacement plan, stating only that he has “concepts of a plan.”
Public health infrastructure
Harris’ tenure in the Senate, from January 2017 to January 2021, shows a consistent pattern of supporting public health infrastructure. She co-sponsored several bills aimed at and .
Harris also advocated for more federal funding to address public health emergencies, such as the and the .
During Trump’s presidency, however, he made significant cuts to public health programs. The to the Centers for Disease Control and Prevention and other public health agencies, arguing that they were necessary for fiscal responsibility. These proposals drew criticism for potentially undermining the nation’s ability to respond to public health emergencies, during the early days of the COVID-19 pandemic. Trump frequently has responded to these criticisms by asserting he “” rather than essential services.
Drug pricing policy
Harris has also supported legislation to lower drug prices and increase transparency in the pharmaceutical industry. She , which aimed to allow the federal government to negotiate drug prices for Medicare directly. She also supported efforts to import cheaper prescription drugs from Canada. Her record reflects a focus on reducing costs for consumers and .
Trump’s record on drug policy is mixed. While Trump took credit for some decreases in prescription drug prices during his presidency, his administration’s most significant regulatory changes . The administration’s attempts to implement a rule faced and did not lead to immediate changes.
Trump also ended a rule that would have , citing concerns over its legality.
Child abuse and domestic violence
Harris has a strong record of advocating for the prevention of child abuse and domestic violence. During and as a senator, Harris pushed for legislation that and . She has consistently services and .
Trump’s record on these issues is less defined, but his administration did , which aimed to keep more children safely at home and out of foster care by providing new resources to families. However, critics argue that the Trump administration’s to combat child abuse and domestic violence. In addition, some experts suggest that Trump’s contributed to an increase in child trauma during his administration.
