Kamala Harris is staking out health, and especially reproductive rights and affordable healthcare, as a central issue in her historic campaign for the US presidency, experts say.
The first ad for the Harris campaign, released on Thursday, prioritized bodily autonomy, safety from gun violence, and affordable healthcare alongside issues like child poverty and the rule of law.
Reproductive rights will be “far and away” the driving focus of Harris’s health-related messages – and her entire campaign – as well as prioritization of affordable healthcare and medications, according to Drew Altman, president of KFF, a nonpartisan health policy organization.
“If Harris wins this election, I think it would be because of abortion bans and because of Dobbs,” said Greer Donley, associate professor at the University of Pittsburgh School of Law. “Abortion is a huge issue this election cycle … and I think it will really help the campaign to capitalize on all of the momentum and all of the rage and anger about abortion bans.”
In the wake of the Dobbs decision overturning the right to abortion, the Biden-Harris administration has “done an extraordinary job on this issue with the tools that they have”, said Sabrina Corlette, research professor at Georgetown University’s Center on Health Insurance Reforms.
The administration solidified telehealth access for abortion, allowed veterans affairs hospitals to provide abortion counseling and services, clarified the Hipaa privacy rules to make sure health employees don’t give protected information to law enforcement, and made sure that abortion, miscarriage, stillbirth and other reproductive healthcare are entitled to accommodations under the Pregnant Workers Fairness Act.
“They did a lot,” Donley said.
In other aspects of health, the administration has built on the Affordable Care Act and the Medicaid program to expand coverage and affordability, and began negotiating Medicare drug pricing.
“We have seen a real improvement in the numbers of people who have health insurance, and new resources to make health insurance more affordable,” Corlette said. “I would expect a Harris administration to try to build on and expand the gains in the Affordable Care Act,” also known as Obamacare.
Harris’ campaign would probably go on the offense, Altman said, calling out Trump’s policies and proposals to cut immensely popular health programs and contrasting them with gains over the past three years.
Her posture probably “will be characterized much more by attacking Trump on positions she’ll claim he will take on healthcare than by advancing her own healthcare positions”, Altman said.
As a senator, Harris was the first to co-sponsor the Medicare for All legislation put forward by the Vermont senator Bernie Sanders, and as a presidential candidate in 2020, she unveiled her own version of a similar plan.
In her time in Congress, Harris also sponsored a bill to prohibit certain abortion restrictions and she introduced a bill to require public and private health insurers to cover medications that prevent HIV infections.
But “I don’t think the past is going to be terribly relevant”, Altman said. As a presidential candidate, Harris needed to rally the base and appeal to undecided voters, he said. “I would expect her to continue the kind of aggressive incrementalism that we’ve seen from the Biden administration.”
One of the first healthcare battles facing a Harris administration would be the extension of the Affordable Care Act tax credits originally enacted in 2021, now scheduled to expire at the end of 2025, Corlette said. “That’s going to be a really important, critical battle, and I expect that she will champion a permanent extension of those – because that’s just had a huge impact on the affordability of health insurance coverage for a lot of people.”
Republicans have proposed capping and cutting Medicaid, a “very popular” program that covers almost 90 million Americans, Altman said. Some conservative Republican groups have also put forward fundamental changes to Medicare, which Altman calls “politically a sacrosanct program”.
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Trump and Vance have proposed weakening protections for people with pre-existing conditions, which are “immensely popular”, Altman said, as well as major changes to or even repealing the Affordable Care Act.
Republican groups have also revived a focus on tax-preferred health savings accounts, in an effort to make healthcare more consumer-driven.
“What you’d likely see under a Trump administration is a dismantling of the federal government’s involvement in healthcare,” Corlette said. Yet “one of the biggest pain points for Americans right now is the cost of healthcare – not just the cost of health insurance, but actually the cost when they go to the hospital or go to the doctor,” she said.
On abortion, Trump has proposed leaving the issue to the states – nearly one-third of which have total abortion bans.
“That is not a position that is consistent with the majority of the American people,” Donley said. “It’s radical.”
Trump’s abortion plank also invokes fetal personhood, which could make abortion, IVF procedures, and miscarriages prosecutable as murder. The concept of fetal personhood, wherein a zygote, embryo or fetus has the same rights as people, is “very scary. It’s scary as everyone suggests it is, and not just for abortion,” Donley said.
While Biden’s administration has made major strides on abortion, “it’s never been an issue that I think he personally has felt comfortable with,” Corlette said. Biden rarely even says the word “abortion”.
Harris, on the other hand, has been much more outspoken about reproductive rights.
Whoever wins this election could one day nominate new justices to the US supreme court, if some of the older justices were to leave the court.
“If Harris serves eight years, then she has the potential to really change the composition of the supreme court,” Donley said.
“That could be a method to get Dobbs overturned. And obviously that would have implications that are far bigger than abortion.”