Which Presidential Candidate Would Be Better for Your Health?

 

Access to affordable healthcare and having a choice in providers and treatments are important for everyone, but for those with chronic pain or illness, healthcare issues are especially critical. With the elections rapidly approaching, or, in some cases, with early voting already underway, it’s important to consider which 2024 candidates will better serve you in this vitally important area. This article will present a summary of the differing policies of Kamala Harris and Donald Trump as they affect your health. It’s up to you to decide which positions you prefer.

Affordable Care Act (ACA):

Kamala Harris is committed to preserving and expanding the ACA, including its protections for people with pre-existing conditions and support for low-income families. The Harris campaign warns that repealing the ACA, which Trump has historically advocated for, could lead to millions losing coverage or facing higher premiums.

Trump has indicated he would seek to repeal the ACA but has not provided a clear alternative, stating that his goal is to make health care more affordable. During his presidency he tried multiple times along with Republicans in Congress to repeal the ACA and failed. At the debate with Harris in September, 2024, when Trump was asked what his healthcare plan was, he said he had “concepts of a plan”. KFF  WHYY

Medicare

Kamala Harris: Harris advocates for protecting  and expanding Medicare. She supports efforts to increase taxes on high earners to help fund the program, ensuring its long-term solvency without cutting benefits. Harris is also committed to expanding Medicare benefits, particularly in areas like broadening the program to cover more services, such as in-home care for seniors. Money  Ballotpedia tin

Harris is also focused on making prescription drugs more affordable through Medicare negotiations, a cornerstone of the Biden-Harris administration's healthcare reforms.

Harris has proposed an expansion of Medicare to cover long-term home care for seniors and people with disabilities. Her plan aims to allow older adults to "age in place" by covering home health aides and other services, reducing the reliance on costly nursing home care. This proposal is part of a broader effort to support family caregivers, often referred to as the "sandwich generation," who care for both children and aging parents. Harris plans to fund this expansion by leveraging Medicare savings from drug price negotiations and reducing hidden costs within the pharmaceutical industry. However, her proposal would require congressional approval to be enacted, and the estimated cost could reach $40 billion annually.  KFF  AJMC

 

 

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Donald Trump has stated that he will protect Medicare without raising taxes or cutting benefits. His approach focuses on boosting economic growth as a way to sustain the program. Trump supports Medicare Advantage, which allows beneficiaries to use private health insurance plans funded by Medicare, signaling a preference for increased privatization within the system. Studies have shown that, while Medicare Advantage plans may provide more perks like free gym memberships, they are more restrictive when someone is ill than traditional Medicare. Subscribers have fewer choices and less benefits so that out-of-pocket expenses may be higher.

During his previous term, Trump signed executive orders aimed at lowering prescription drug costs, though some provisions were later reversed. No reductions in drug prices occurred as result of negotiations during his administration. Money  AARP

Donald Trump, while expressing support for "at-home senior care" during his 2024 campaign, has not put forward a specific detailed plan to expand Medicare for home care. His general approach includes shifting resources to support home care and providing tax credits for unpaid family caregivers. However, there are uncertainties about whether his proposals would significantly alter Medicare or Medicaid to increase home care coverage, especially given his past support for Medicaid cuts. KFF  KFF

Medicaid

Kamala Harris has supported continuing and expanding Medicaid as Vice President, particularly under the Affordable Care Act (ACA). Her administration has worked to improve Medicaid coverage, including expanding postpartum coverage, promoting access to behavioral health services, and addressing health-related social needs, such as housing and food security, through Medicaid waivers. Harris is also committed to Medicaid expansion in the remaining states that have not adopted it and opposes efforts to impose work requirements on beneficiaries. Her policies focus on ensuring broader and more equitable access to Medicaid services, especially for low-income populations, the elderly, and people with disabilities. Managed Healthcare Executive  KFF

Donald Trump: During his presidency, Trump favored restricting Medicaid by introducing work requirements and granting states the flexibility to impose eligibility restrictions, such as premiums and coverage lockouts for non-compliance. He also supported limiting Medicaid expansion and pursued policies aimed at reducing federal spending on the program. His 2024 campaign suggests a continued focus on ensuring Medicaid covers only those deemed eligible, potentially reintroducing work requirements and other restrictions. Trump's position centers around tightening eligibility and reducing Medicaid's overall cost. POLITICO  Managed Healthcare Executive

Project 2025

Project 2025 is a conservative blueprint for a Republican administration that was developed by close associates of Trump, many of whom it is expected will serve in his administration if he is re-elected. It outlines in more detail than Trump’s platform several major changes to healthcare, particularly focusing on Medicare and Medicaid, with a goal of reducing federal spending and promoting private market solutions.

 

Medicare: Project 2025 aims to make Medicare Advantage (MA), the private plan alternative to traditional Medicare, the default option for all enrollees. This shift would lead to increased reliance on private insurers, potentially limiting beneficiaries' choices of doctors and hospitals, as MA plans often have narrower provider networks compared to traditional Medicare. Critics argue that this change could increase out-of-pocket costs for seniors and reduce access to certain services. NerdWallet: Finance smarter Center for American Progress

Additionally, Project 2025 proposes ending the Medicare drug price negotiation program, which could lead to higher prescription drug costs for beneficiaries. Center for American Progress

Medicaid: The plan proposes significant cuts to Medicaid, including switching to a block grant model where the federal government provides states with a fixed amount of funding, rather than covering a percentage of costs. This change could reduce the overall federal contribution to Medicaid, making it harder for states to meet rising healthcare costs and serve growing numbers of beneficiaries. The project also introduces work requirements for "able-bodied" Medicaid recipients and lifetime caps on benefits, which could lead to many low-income individuals losing coverage NerdWallet: Finance smarter   9News

Overall, Project 2025 focuses on reducing federal involvement in healthcare and shifting more responsibility to states and private insurers, a move that could reduce costs but may also limit access to care, especially for vulnerable populations.

Medical Marijuana and Marijuana Legalization

Kamala Harris is a strong proponent of marijuana legalization. She supports fully legalizing marijuana at the federal level and has been vocal about the need for criminal justice reform tied to cannabis convictions. As a senator, she co-sponsored legislation such as the Marijuana Opportunity Reinvestment and Expungement (MORE) Act, which aims to legalize cannabis, expunge criminal records, and invest in communities affected by the war on drugs. Harris has also supported banking reforms to help cannabis businesses operate more freely within the financial system. Since becoming vice president, she has aligned with the Biden administration’s call for rescheduling marijuana, which would lower its classification and open doors for medical research and broader legalization efforts. Truthout App

Donald Trump’s stance on marijuana has evolved over time. During his presidency, his administration took a mixed approach—while Attorney General Jeff Sessions rescinded protections for state-legal cannabis businesses, Trump himself expressed support for state-led legalization efforts. Recently, Trump has voiced support for marijuana reform at the state level, particularly endorsing a Florida ballot initiative for recreational use. He has also supported federal legislation that would give states more autonomy over cannabis laws and improve banking access for cannabis businesses. However, his broader position on national legalization remains less aggressive than Harris's, focusing more on state rights and regulations. POLITICO  App

 

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The Opioid Crisis

Kamala Harris: The Biden-Harris administration has made combating the opioid crisis a central focus, investing heavily in treatment, harm reduction, and prevention. Key initiatives include removing barriers to accessing medication-assisted treatments like methadone and expanding telehealth services for opioid use disorder. The administration has also made naloxone (an overdose reversal drug) more widely available, including over-the-counter access, and has pushed for increased funding for harm reduction programs. Additionally, the administration has worked to crack down on fentanyl trafficking by deploying new detection technologies at U.S. borders and enhancing law enforcement efforts. KFF The White House

Donald Trump took a more enforcement-oriented approach during his presidency, focusing on border security to stop the flow of illegal drugs, particularly fentanyl. His administration declared the opioid crisis a public health emergency and implemented several policies, such as supporting medication-assisted treatment and signing legislation to increase funding for treatment programs. However, Trump also proposed harsh penalties, including the death penalty for some drug traffickers, and emphasized the importance of reducing the supply of illegal opioids over harm reduction strategies. KFF  The White House Top of Form

Access to Alternative Treatments

Kamala Harris supports broadening access to alternative treatments, especially in the context of healthcare reform. As part of the Biden-Harris administration, she has pushed for expanding access to a wide range of healthcare services, including alternative and integrative health options, through policies such as Medicaid expansion and improved insurance coverage. Her advocacy for healthcare equity also suggests support for treatments that cater to diverse populations, particularly in underserved communities. KFF   AJMC

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Donald Trump has not been as vocal about expanding access to alternative treatments. His administration focused more on deregulating traditional healthcare markets and reducing costs through privatization. His administration took steps to roll back some healthcare regulations, but these actions generally focused on reducing government intervention rather than promoting access to alternative therapies. AJMC  KFF

Negotiating Drug Prices

Kamala Harris has been a strong advocate for allowing Medicare to negotiate drug prices. A key legislative achievement of the Biden-Harris administration was the Inflation Reduction Act (IRA), which gave Medicare the authority to negotiate prices for certain prescription drugs for the first time. Harris cast the tie-breaking vote in the Senate to pass the IRA in 2022. This legislation also includes measures to cap insulin prices for seniors at $35 per month and limit out-of-pocket drug costs for Medicare beneficiaries. Harris has emphasized that these provisions are critical for making medications more affordable and reducing the financial burden on patients.  KFF  AJMC

Donald Trump has supported lowering drug prices but has taken a different approach. During his presidency, he proposed the "Most Favored Nation" pricing model, which aimed to tie the prices of certain Medicare drugs to the lowest prices paid by other countries. However, this initiative faced legal challenges and was never implemented. Trump also pushed for policies to allow drug imports from other countries, particularly Canada, as a way to reduce prices. While Trump criticized high drug prices and proposed some reforms, his administration did not succeed in implementing comprehensive drug price negotiations through Medicare. AJMC  KFF

Reproductive Health and Abortion

Kamala Harris is a strong advocate for reproductive rights, including access to abortion and contraceptives. Her administration has worked to expand access to abortion medication via telehealth and fought against state restrictions.

Donald Trump appointed three anti-abortion Supreme Court Judges who have overturned Roe v Wade, the Supreme Court decision that guaranteed the right to abortion. He has advocated leaving abortion laws to the states and supporting initiatives that could severely limit access to abortion pills. His stance on medication abortion has been inconsistent, with proposals to restrict access federally. He has wavered on whether he would support a national abortion ban. KFF  KFF

 

Contraceptive Access

Kamala Harris supports broad access to contraception, including making birth control available over the counter and ensuring coverage under Medicare.

Donald Trump’s administration introduced regulations that restricted federal funding for clinics offering both abortion services and contraception. His platform does not detail new policies for promoting contraceptive access but suggests that states could impose their own restrictions. KFF

 

Maternal Health

Kamala Harris has prioritized maternal health, championing Medicaid expansion for postpartum care and addressing racial disparities in maternal outcomes.

Donald Trump’s policies have focused more on improving care for opioid use during pregnancy but have been criticized for lacking comprehensive maternal health support, KFF  WHYY

 

Environmental Issues Which Affect Health

 

Kamala Harris has consistently supported strong environmental protections aimed at addressing climate change and improving public health. As part of the Biden-Harris administration, she helped implement the Inflation Reduction Act, which allocates $369 billion towards clean energy and emissions reduction, including investments in renewable energy, electric vehicles, and efforts to lower greenhouse gas emissions. Harris emphasizes the need for robust environmental regulations, holding polluters accountable, and supporting communities disproportionately affected by climate change. Her policies also prioritize improving air and water quality, which directly impact public health, particularly for vulnerable populations. Harris supports decarbonization and infrastructure resilience to mitigate climate-related disasters. Carbon Brief  Katie Couric Media

 

Donald Trump focuses on expanding the fossil fuel industry, deregulating environmental protections, and reducing federal support for clean energy. During his previous administration, Trump rolled back several key environmental regulations, including withdrawing the U.S. from the Paris Agreement and weakening methane emissions standards. He views these rollbacks as necessary to boost economic growth and energy independence. If re-elected, Trump plans to continue promoting oil, gas, and coal production, while cutting government investment in renewable energy and electric vehicles. His policies have often favored reducing environmental oversight, which critics argue could increase pollution and related health issues, such as respiratory illnesses.  Carbon Brief  Katie Couric Media STPP

 

Conclusion

The 2024  candidates differ significantly on how they would address health policy that very directly affects you. I strongly recommend that you prioritize this issue in deciding which candidate is better for your health. Those of us who have lost our health truly understand how important affordable healthcare and healthcare choices are.

 

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The author, Cindy Perlin, is a Licensed Clinical Social Worker, certified biofeedback practitioner and chronic pain survivor. She is the founder and CEO of the Alternative Pain Treatment Directory and the author of  The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She's located in the Albany, NY area, where she has been helping people improve their health and emotional well-being for over 30 years. See her provider profile HERE.