Harris vs. Trump: An overview of proposed healthcare plans

Healthcare plans may not be a primary issue for both candidates, but it’s certainly been part of the political discourse — showing up on the debate stage, at campaign rallies, and in interviews. The presidential election has the potential to drastically impact healthcare delivery in the United States, from reproductive rights to insurance coverage.

Here is Vice President Kamala Harris’ plan should she be elected president, found on the Harris-Walz campaign website:

“Vice President Harris will make affordable health care a right, not a privilege by expanding and strengthening the Affordable Care Act and making permanent the Biden-Harris tax credit enhancements.” 

While healthcare is not the central focus of Former President Donald J. Trump's 2024 campaign, it is mentioned as one of the key elements in the official 2024 Republican Party Platform. 

Here is what the platform says about healthcare under the promise to “bring back the American dream and make it affordable again for families, young people, and everyone”:

“Republicans will increase Transparency, promote Choice and Competition, and expand access to new Affordable Healthcare and prescription drug options. We will protect Medicare, and ensure Seniors receive the care they need without being burdened by excessive costs.”

Let’s dive into the similarities and differences between the candidates’ healthcare plans and how they might affect healthcare providers and patient care.

Both Harris and Trump have acknowledged concerns about the rising costs of healthcare in the US, and that they want to lower costs for consumers — but they propose different strategies on how to do so.

Before we jump into the differences, here are some similarities in their plans. Both candidates support:

While both candidates share some common goals in reducing healthcare costs, their approaches diverge sharply when it comes to the Affordable Care Act (ACA). Let’s take a closer look at how Harris and Trump differ on this healthcare policy.

The candidates differ in their plans for the Affordable Care Act (ACA), also known as “Obamacare,” which expanded health insurance coverage for the uninsured and implemented reforms to the health insurance market.

Trump's administration took several steps aimed at repealing and replacing the ACA.

Former President Trump’s record, according to KFF:

As a senator and in her current role, Harris has supported the ACA and sought to expand its coverage and protections.

Vice President Harris’ record, according to KFF:

Here is what their respective campaigns have said regarding their plans if elected.

What the Harris-Walz campaign says:

What the Trump-Vance campaign says:

While the ACA’s future depends on the United States Congress, the presidential candidate who’s elected will likely sway its path.

According to the Congressional Budget Office, Trump’s original plan to repeal the ACA in 2017 could have lowered the federal budget deficit by an estimated $119 billion, but it also may have increased the number of people uninsured by 23 million. However, since on the campaign trail, Trump has said he wishes to improve the ACA or replace it with something better.

Providers may experience changes in patient volume, as patients could respond to potential shifts in healthcare coverage. This may include a drop in demand if there is a rise of uninsured patients, since they are less likely to seek care.

Should Harris be elected and successfully enact her plan to expand and stabilize the ACA, it would likely result in a larger insured patient base. This could lead to a higher and more predictable patient volume and reduce levels of uncompensated care.

The candidates take different approaches to healthcare policies, each with unique strategies that could shape the future of care. Harris focuses on expanding federal protections and funding, while Trump aims to reduce regulations to promote competition and consumer choice. Here are some of the other key differences between their healthcare plans.

Both Trump and Harris want to lower prescription drug prices, but they have vastly different plans to achieve the desired result.

The Biden-Harris administration backed the Inflation Reduction Act (IRA), with Harris casting the tie-breaking vote in the US Senate. The IRA requires the government to negotiate prices for some Medicare-covered drugs. This capped the cost of insulin at $35 per month. Additionally, the administration has limited the annual cost of prescription medication for seniors to $2,000.

Part of Harris’ plan is to expand the $35 cost cap to all Americans and accelerate negotiations to cover more drugs and lower prices.

The drug industry has fought the negotiation program, and some Republicans have said they want to repeal it. Trump’s campaign has declined to comment on whether he would repeal the program. However, according to The New York Times, former senior Trump administration official Joe Grogan said if Trump and Republicans were to repeal it, they would most likely want to replace it with an alternative program to reduce drug costs for the government and older people.

While Harris’ healthcare plans revolve around increasing federal protections and subsidies, Trump focuses on deregulation and increased competition. The Trump administration also sought to cap insulin for Medicare at $35, but it established a voluntary model for Medicare Part D plans. He also created a pathway to allow states to import prescription drugs from Canada.

Trump’s administration also proposed several methods for lowering prescription drug costs that didn’t go into effect, including:

On the 2024 campaign trail, the Trump administration has said there is no push to renew the “most favored nations” drug policy. His current plan is to make healthcare affordable by “increasing transparency, promoting choice and competition, and expanding access to new affordable healthcare and prescription drug options.”

This is where the Republican and Democratic presidential candidates differ greatly. Harris strongly supports reproductive rights. In contrast, Trump has publicly taken credit for supporting efforts to overturn Roe v. Wade, emphasizing a state's rights approach to abortion policies.

Here is what the 2024 GOP Platform says about abortion under their “Government of, by, and for the people” promise: 

“We proudly stand for families and Life. We believe that the 14th Amendment to the Constitution of the United States guarantees that no person can be denied Life or Liberty without Due Process, and that the States are, therefore, free to pass Laws protecting those Rights. After 51 years, because of us, that power has been given to the States and to a vote of the People. We will oppose Late Term Abortion, while supporting mothers and policies that advance Prenatal Care, access to Birth Control, and IVF (fertility treatments).”

Harris has been vocal about her disagreement with the Supreme Court’s decision in Dobbs v Jackson Women’s Health Organization, which overturned Roe v. Wade.

Harris has said that if Congress passes a bill to restore reproductive freedom nationwide, she will sign it, and she would veto a national abortion ban should it make it to her desk.

Here is what the Harris-Walz campaign website says about reproductive freedoms:

“Vice President Harris and Governor Walz trust women to make decisions about their own bodies.”

The availability of medical abortion pills has also been a topic between the candidates. Under the Biden-Harris administration, policies have been implemented to expand access to medication abortion. 

Trump’s statements about medication abortion have been inconsistent.

Another issue on which Harris and Trump differ is the right to contraceptive care. Harris supports contraceptive care, including broader access to it. She proposed the Right to Contraception Act, which the majority of Republican members of Congress (including Senator JD Vance) either abstained from voting on or opposed. 

Trump said he wouldn’t ban access to contraceptives, but he enacted several policies that made it more difficult to obtain during his presidency. The Trump administration made it easier for employer-based health plans not to cover contraception, according to the Rollins School of Public Health.

He also posted this on Truth Social in May: “I HAVE NEVER, AND WILL NEVER ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL, or other contraceptives.”  

Senator JD Vance said that if elected, Trump would aim to cut federal funding to Planned Parenthood, the nonprofit organization that provides sexual healthcare and sexual education in the United States and globally.

Abortion restrictions were part of Trump's healthcare agenda while he was president. His administration introduced regulations preventing clinics that offered abortions or referrals from receiving federal funds, potentially cutting $60 million from Planned Parenthood. Planned Parenthood challenged the policy in court, which delayed and affected the implementation of the funding restrictions. Trump also issued an executive order restricting $9 billion in foreign aid to organizations discussing or providing abortions. 

Although the Biden administration reversed these measures in 2021, the anticipation of funding cuts had already led to some clinic closures, affecting global reproductive health.

Here are details both candidates have provided on the topic of Medicare and Medicaid.

According to Harris’ campaign website, she plans to strengthen Medicare by increasing taxes on high-income earners, including millionaires and billionaires. She is also proposing to expand Medicare by having it cover home health aide visits and other services. This change would allow older people to receive care in their homes rather than moving into nursing facilities.

"They want to stay in their home. They don't want to go somewhere else. Plus, for the family to send them to a residential care facility to hire somebody is so expensive," Harris said during an appearance on ABC News’ "The View."

To pay for this expansion, Harris intends to allow Medicare to continue negotiating drug prices with large pharmaceutical companies to save costs, which could then be used to fund home health aide services. 

On the topic of Medicare, Trump's campaign platform states his administration would “fight for and protect Social Security and Medicare with no cuts, including no changes to the retirement age.” His official policy platform also states that Republicans will protect Medicare's finances by preventing the addition of new illegal immigrants. They also vow to strengthen Medicare for future generations.

As for Medicaid policies, the Republican Party platform doesn’t include details regarding their stance on it. However, Trump's administration during his presidency proposed and supported unsuccessful efforts to repeal and replace the ACA, including Medicaid expansion. More recently, Republican proposals in the RSC FY 2025 budget and Project 2025 seek to lower the higher match rate for the Medicaid expansion group, and remove expanded Marketplace subsidies. 

The Harris plan includes efforts to protect and strengthen Medicaid and the ACA, with policies that either maintain or increase federal Medicaid spending.

This chart by KFF uses the candidates' past records to predict Medicaid outcomes.

Medical debt affects approximately 100 million Americans, according to CBS, with some individuals seeking additional work or reducing spending in areas like food to manage their financial burdens.

Harris has voiced support for increased government spending to buy and retire patients’ old medical debt. She also supports the Consumer Financial Protection Bureau's (CFPB) proposed rule that would prevent medical bills from appearing on consumer credit reports, which is expected to be finalized early next year. Harris' running mate, Minnesota Gov. Tim Walz, has previously mentioned that he and his family experienced medical debt challenges earlier in his life, and in June 2024, he signed legislation to reduce the burden of medical debt for Minnesotans.

Congressional Republicans have long criticized the CFPB, but Trump hasn't stated if he would maintain the medical debt protections if re-elected. If insurance premiums were to rise, it could contribute to increased medical debt rates. However, Trump's campaign has not released specific proposals addressing medical debt.

Even with the presidential candidates campaigning on other platforms, this election has the potential to redefine how healthcare is delivered and accessed in the US. Changes in healthcare policy could influence patient coverage, affecting patient volumes and financial dynamics for healthcare providers. 

To stay informed, healthcare providers should engage with trusted sources for updates and analysis. Monitoring campaign announcements can also provide insights into potential policy changes should either candidate be elected.

The future of healthcare depends on the election outcome and subsequent actions by Congress. Providers must be prepared to adapt to new policies and continue delivering high-quality care in an evolving environment.

For more insights into the current independent medical practice landscape, explore the State of the independent practice report.