Potential Harris and Trump Health Policy Agendas
The 2024 presidential election campaigns have not focused on health policy (except for reproductive health care) and the two major candidates have made few policy speeches. Nonetheless, Manatt Health has assembled this infographic that compares the candidates’ positions, to the extent it can be discerned from their past actions and statements, and those of their allies.
Candidate policy positions have been divided into the nine topics below. To expand the table, click the relevant header to view the specific policy proposals for each candidate.
Medicaid
Policy |
Kamala Harris1 |
Donald Trump2 |
Expanding Medicaid |
✓ Support a new federal initiative to provide coverage for low-income adults in states that don’t take up ACA expansion |
X Overhaul Medicaid program funding by instituting block grants and per-capita caps Reduce federal funding for certain categories of Medicaid enrollees (e.g., expansion adults) Support state flexibility to limit certain benefits (e.g., a Non-Emergency Medical Transportation benefit) |
Requiring Work or Community Engagement as a Condition of Enrollment |
X |
✓ |
Covering Health-Related Social Needs (HRSN) |
✓ |
✓ |
Prescription Drug Pricing
Policy |
Kamala Harris1 |
Donald Trump2 |
Importing Drugs from Other Countries |
✓ |
|
Using International Reference Pricing |
✓ |
✓ |
Limiting Drug Price Increases |
✓ |
✓ |
Capping Insulin Out-of-Pocket (OOP) Costs |
✓ |
? |
Redesigning Medicare Part D |
✓ |
✓ |
Reducing OOP Drug Costs |
✓ |
X |
Negotiating Drug Prices |
✓ |
? |
Enhancing Transparency of PBM Practices |
✓ |
|
Leveraging State Prescription Drug Affordability Boards (PDABs) to Control Prescription Drug Costs |
✓ |
? |
Addressing Drug Shortages |
✓ |
̶ |
Reproductive Health
Policy |
Kamala Harris1 |
Donald Trump2 |
Guaranteeing Abortion Access |
✓ |
X |
Addressing Maternal and Infant Health |
✓ Increase investments in maternal health and the Maternal and Child Health Block Grant Support mothers and policies that advance prenatal care Address racial, ethnic and geographic disparities |
✓ Increase investments in maternal health and the Maternal and Child Health Block Grant Support mothers and policies that advance prenatal care |
Accessing Family Planning Services |
✓ Support access to contraception, in vitro fertilization, and other family planning services |
X Reinstate the gag rule for Title X ✓ |
Innovation
Policy |
Kamala Harris1 |
Donald Trump2 |
Working with China |
✓ Cooperate to block fentanyl imports into the U.S. |
X |
Enhancing Biosimilar Competition |
✓ |
|
Covering Breakthrough Drugs and Devices |
✓ |
✓ |
Supporting Development of Rare Disease Products |
✓ |
✓ |
Supporting Medical Research at Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and FDA |
✓ Expand support for ARPA-H |
X |
Encouraging the Use of Artificial Intelligence (AI) in Health Care |
✓ Promote responsible use of AI in health care, including by implementing guardrails to limit bias |
✓ |
Behavioral Health6
Policy |
Kamala Harris1 |
Donald Trump2 |
Improving the Behavioral Health Workforce |
✓ Expand the behavioral health workforce via investments in workforce development programs Support expansion of school-based services to improve youth mental and behavioral health |
✓ |
Enhancing Biosimilar Competition |
✓ Crack down on fentanyl trafficking |
Affordable Care Act
Policy |
Kamala Harris1 |
Donald Trump2 |
Extending Enhancements to APTCs to Purchase Marketplace Coverage |
✓ |
X |
Leveraging Section 1332 State Innovation Waivers |
✓ |
✓ |
Encouraging Alternatives to ACA Marketplace Coverage |
X |
✓ |
Medicare
Policy |
Kamala Harris1 |
Donald Trump2 |
Expanding Medicare Benefits |
✓ |
✓ |
Regulating MA |
✓ Limit utilization management policies |
✓ |
Health Equity and Non-Discrimination
Policy |
Kamala Harris1 |
Donald Trump2 |
Accessing Gender Affirming Care |
✓ Defend Section 1557 rule defining protections against discrimination on the basis of gender identity and sexual orientation |
X Rescind and replace Section 1557 rule defining protections against discrimination on the basis of gender identity (and sexual orientation) |
Improving Racial and Gender Health Disparities |
✓ Prioritize improving health outcomes for women, people with disabilities and LGBTQIA+ Americans by addressing health equity Improve collection of race, ethnicity, sexual orientation and gender identity data |
X Renew Executive Order 13950 characterizing systemic racism as a “divisive concept”9 |
Enhancing Access to Health Care for Non-Citizens |
✓ Encourage state creativity in affordable health coverage programs for noncitizens (e.g., Marketplace-based strategies, Basic Health Program-like programs) |
X Support termination of the DACA program and revoke section 1332 waivers that allow additional non-citizens to enroll in Marketplace coverage Protect Medicare solvency by keeping “illegal immigrants [from] the rolls of Medicare” |
Provider and Health Care Access
Policy |
Kamala Harris1 |
Donald Trump2 |
Improving Rural Health |
✓ Invest in community health centers, programs that attract providers to practice in rural areas Improve telehealth access Invest in mobile health clinics |
✓ Modify payments to Rural Health Clinics10 Remove requirements on rural hospitals to address trends in hospital closures Maintain funding for Rural Health Outreach grants |
Ensuring Access to Telemedicine |
✓ |
|
Addressing Health Care Consolidation and the Role of Private Equity in the Health Sector |
✓ |
✓ Increase choice and promote transparency and competition |
Protecting Consumers from Medical Debt |
✓ |
̶ |
Encouraging Price Transparency |
✓ Eliminate surprise medical bills |
Legislation is required for most of the major health care reforms proposed by Harris and Trump. Therefore, the makeup of Congress will impact how much of the President’s agenda is actually enacted into law. Key: ✓ represents policies supported by the candidate in campaign and other written materials. ̶ ̶ represents policies not included in campaign platform statements or that the candidate is likely to oppose. X represents policies actively opposed by the candidate. ? represents policies that are not included in campaign platform statements but where the candidate’s past statements or actions contradict the party’s historical stance on an issue. Where candidates both pledge action on an issue, but the proposed actions vary significantly, a short description is captured under the check mark. Candidate positions that are materially the same are indicated in purple. |
1 In this infographic, Vice President Harris’ positions are based on campaign statements as well as executive activity during the Biden-Harris Administration which is largely expected to continue.
2 In this infographic, President Trump’s positions are based on campaign statements as well as executive activity during his first term that is expected to continue.
3 While President Trump has not weighed in on using Medicaid to address HRSN, the Heritage Foundation’s Project 2025 chapter on HHS notes that CMS’s overhaul of current waiver processes should “include adding Section 1115 waiver requirements in some cases (such as imposing work requirements for able-bodied adults) while rescinding requirements in others (such as non-health care benefits and services related to climate change).” (Emphasis added.)
4 H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, see Statement of Administration policy on H.R. 3 here.
5 The Trump fiscal year (FY) 2021 budget proposed decreasing NIH funding by more than $2 billion.
6 In this context, “Behavioral Health” refers to both mental health services and SUD services.
7 The Trump Administration’s FY 21 HHS budget request proposed level funding for the Health Resources and Services Administration’s Behavioral Health Workforce Development Programs.
8 A recent CBO report published in response to an inquiry from several House Republican leaders on the budgetary effects of the enhanced APTCs estimated that making these APTCs permanent would increase the budget deficit by an estimated $335 billion over the next ten years.
9 Executive Order 13950, “Combating Race and Sex Stereotyping,” September 22, 2020. This executive order defines a “divisive concept” as: “concepts that (1) one race or sex is inherently superior to another race or sex; (2) the United States is fundamentally racist or sexist; (3) an individual, by virtue of his or her race or sex, is inherently racist, sexist, or oppressive, whether consciously or unconsciously; (4) an individual should be discriminated against or receive adverse treatment solely or partly because of his or her race or sex; (5) members of one race or sex cannot and should not attempt to treat others without respect to race or sex; (6) an individual's moral character is necessarily determined by his or her race or sex; (7) an individual, by virtue of his or her race or sex, bears responsibility for actions committed in the past by other members of the same race or sex; (8) any individual should feel discomfort, guilt, anguish, or any other form of psychological distress on account of his or her race or sex; or (9) meritocracy or traits such as a hard work ethic are racist or sexist, or were created by a particular race to oppress another race.”
10 Note that the President’s proposed budget included a $1.8 billion cut to Medicare payments to Rural Health Clinics over ten years.
Resource List
- 2024 GOP PLATFORM: MAKE AMERICA GREAT AGAIN!
- 2024 Democratic Party Platform.
- Bobby Jindal and Hannah I. Anderson, “Biden-Harris aided illegal immigrants and made Americans pay for it,” Fox News, (July 31, 2024).
- Chris Pope, “Restraining Medicaid’s Budget Busting Waivers,” Manhattan Institute, (May 2, 2024).
- Compare the Candidates on Health Care Policy.
- Donald J. Trump for President: Issues.
- Drew Keyes and Brian Blase, “A Health Policy Agenda for the 118th Congress,” Paragon Health Institute, (December 5, 2022).
- Gabrielle Wanneh and Maaisha Osman, "A Harris Win Could Boost FTC, NIH Drug Pricing Roles Given Presumptive Candidate’s Prior Anticompetitive Crackdown, March-In Support," InsideHealthPolicy, (July 24, 2024).
- Gini Morgan, "Candidates Continue to Outline Their Healthcare Policy Objectives as the Election Nears," Manatt on Health, (September 14, 2020).
- HHS Budget in Brief: FY 2021.
- HHS Budget in Brief: FY 2025.
- Jacob Knutson, "Where VP Kamala Harris stands on hot-button issues," Axios, (July 22, 2024).
- Jessica Karins, "Harris Enters Presidential Race With Health Record That Includes ‘MA For All’ Option, Pharma Lawsuits, Abortion Advocacy." InsideHealthPolicy, (July 21, 2024).
- Kamala Harris: The Vice President.
- Noah Tong, "Trump, Biden admin policy heads agree: Price transparency is here to stay," FierceHealthcare, (May 1, 2024).
- Roger Severino, “Department of Health and Human Services," in Mandate for Leadership: The Conservative Promise (2023), sponsored by the Project 2025 Presidential Transition Project.
- Sally Pipes, “Medicaid Shouldn’t Pay for Housing,” Washington Examiner (March 11, 2024).