Trump vs. Harris: Key differences in healthcare proposals for Medicaid, Medicare, private insurance, abortion

Editor's Note

When it comes to the 2024 presidential election, “Neither candidate addresses a return to the fundamental tenet of healthcare: the patient-physician relationship,” reads the closing line of an “election guide” from Richard Menger MD MPA. In the preceding paragraph, Menger also argues that both candidates also neglect issues around healthcare spending and administrative growth, pointing out various salary disparities and the fact that only 14.5% of healthcare dollars go toward physician services even while administrative roles and executive pay have soared.

As for what the candidates do promise to address, Menger’s guide purportedly takes only three minutes to read in full. However, each topic he outlines links to deeper content specifically on that subject. Published November 2 in Forbes, the article covers the following points of contention:

• Medicaid. Trump’s approach likely includes reduced Medicaid funding, stricter eligibility, and possible ACA repeal, leading to lower enrollment. Harris favors expanding coverage and promoting equity. Medicaid’s limitations impact patient outcomes, with studies showing Medicaid patients face more challenges in accessing care and experience poorer surgical outcomes.
• Private insurance. Employer-based insurance covers 57% of Americans under 65 but has impacted wage growth. Harris now supports expanding ACA subsidies, proposing a permanent extension costing $335 billion, while Trump remains largely silent. Healthcare costs for a family of four reached $23,968 in 2023, with health insurers like UnitedHealth reporting significant profits.
• Abortion. Harris supports codifying Roe v. Wade and expanding access, even suggesting eliminating the filibuster. Trump prefers delegating abortion legislation to the states and supports some limitations, such as a 15-week ban, aligning with a moderate public opinion on restrictions.
• Medicare. Trump claims to protect Medicare, though past budgets indicate possible cuts. Harris advocates expanding Medicare benefits, particularly home health care, costing $40 billion annually. Medicare’s fiscal sustainability remains a concern, and while Medicare drug price negotiations have begun under the Biden-Harris administration, Republicans argue this could harm research and development.