Harris vs. Trump: How Each Candidate Could Affect Health Care Coverage

With one candidate’s last-minute decision to drop out and an assassination attempt on another, It’s safe to say 2024’s has been one of the most turbulent election seasons in history.

And now, the time to cast votes draws near.

No matter which side of the aisle you’re seated on, who you vote for matters — not just because the presidential candidates have substantially different takes when it comes to health insurance and policies related to accessing certain forms of health care, like abortion. The president-elect will likely have an impact on the cost of health care coverage — and potentially even the existence of certain forms of coverage, like private health insurance or marketplace plans.

Below, we’ve broken down the basic health insurance-related stances of Kamala Harris and Donald Trump as of mid-September 2024.

How would a Kamala Harris presidency affect health care coverage?

Back in 2019, Kamala Harris expressed interest in ending private health insurance entirely in favor of a single, government-run plan (also known as single-payer health care). While she quickly walked back this viewpoint, saying she misunderstood the moderator’s question, the rumor that Harris might abolish private health care has stuck.

Almost 20 countries, including Canada, Iceland, Italy, Japan, Portugal and the United Arab Emirates and the United Kingdom, offer single-payer health care coverage. But campaigning to switch to this model is sometimes considered a radical stance in the United States, where private health insurance, usually offered as an employment benefit, has been established for nearly a century. Many Americans fear losing access to their current practitioner and benefits under such a switch.

Fortunately for them, Harris has moved away from the "Medicare For All" outlook, and instead aims to build upon the existing framework she’s supported as part of the Biden administration. "What we need to do is maintain and grow the Affordable Care Act," she said during the September 2024 presidential candidate debate in which she faced off against Donald Trump.

Harris went on to mention that the Affordable Care Act (ACA) made it impossible for insurance companies to deny people with preexisting conditions, intimating that she would work to continue to support those protections. Harris has also proposed an out-of-pocket cap on drug costs of $2,000 per year, regardless of income or coverage, as well as a maximum $35 per month insulin copay. She would also continue the Medicare drug cost negotiations that began earlier this year.

This latter proposition, especially, could spell lower drug prices for many of the 67.4 million Americans on Medicare — specifically those with Medicare Part D prescription drug coverage.

Harris is also expected by experts to champion continued access to and protection of reproductive rights. "I absolutely support reinstating the protections of Roe v. Wade," she said during September’s debate, mentioning not only abortion but in vitro fertilization (IVF) treatments.

She also became the first vice president in United States history to visit an abortion provider in March 2024, when she toured a Minnesota branch of Planned Parenthood.

How Donald Trump would treat health care in his second administration

In September 2016, ahead of his first presidency, Donald Trump clearly stated an intention to repeal the ACA, otherwise known as Obamacare — a proposal which never came to pass.

This time around, though, Trump is returning to the podium with a similar message.

"Obamacare is a catastrophe," he said at a rally in Iowa in January 2024, promising his constituents to "fight for much better health care" than our current marketplace has to offer, also mentioning affordability for the people.

However, his specific strategy remains unclear. In the September 2024 debate, Trump offered, "We are working on things. We’re gonna do it, and we’re gonna replace [Obamacare]" — though he admitted that "until" they found a better alternative, his administration would "run [the marketplace] as good as it can be run."

Trump has recently confounded some of his Republican constituents, however, by promising to require insurance carriers to cover IVF treatments — which are controversial in some anti-abortion groups. (Earlier this year, the Alabama Supreme Court ruled that embryos, many of which are discarded during the IVF process can legally be considered "unborn children.")

The candidate has also recently softened his stance on abortion, even claiming at one point that he’d be voting in favor of increased abortion protection in his home state of Florida. In September’s debate as well, Trump stated clearly that he believes in "exceptions for rape, incest and life of the mother. I believe strongly in it," touting his administration’s success in making abortion a states’ rights issue. "I’m not signing a ban," Trump said later in the debate.

Regardless of who you plan to vote for, it’s important to remember that campaigning isn’t the same as governing — and plenty of candidates have fought their way to the presidency only to fail to uphold promises they made en route. However, keeping candidates’ prospective policies in mind can help you make decisions at the ballot box — and perhaps while choosing your own health insurance coverage, too.