Michigan elections FAQ: Where Trump, Harris stand on health care, drug prices
- Health insurance and drug costs are rising, and polls show voters want the issue addressed
- Kamala Harris wants to expand the Affordable Care Act and Medicare while “leaving room” for private insurance
- Donald Trump says he would replace the Affordable Care Act with a better system, but hasn't provided details
The issue: Prices for pharmaceuticals and health insurance continue to rise at rates exceeding inflation in the U.S., making the cost for health care per capita far higher than any other nation and leaving millions unsure whether they can afford life-saving services and medicine.
Services provided under the Affordable Care Act, also known as Obamacare, have nearly doubled in popularity among voters in the past decade despite pushback from Republicans. Medicare protections and prescription drug costs are projected to influence the vote of many older Americans.
The majority of voters say health care should be a top priority for lawmakers this year — even more believe it isn’t being discussed enough.
How it is important to Michigan: In Michigan, much of the health care debate recently has focused on the cost of medications, including efforts to establish a Prescription Drug Affordability Board. The cost of prescription drugs and continued access to Medicare rank among the top issues for Michigan voters over the age of 50, according to a recent survey by the state AARP.
That’s part of the larger concern about accessibility and the cost of health care.
About 9% of Michiganders reported having medical debt between 2019 and 2021, according to the most recent survey data available. The result: Some Americans say they cut spending on other essentials or borrow money.
The Affordable Care Act, meanwhile, continues to impact millions of Michiganders, guaranteeing no-cost access to a variety of preventive services and protections for those with preexisting conditions.
Nearly 1.8 million lower-income residents have health insurance benefits through Healthy Michigan, the state’s expanded access program created and largely funded through the Affordable Care Act.
More than 418,000 Michiganders also get subsidized health insurance on the Health Insurance Marketplace established by the Affordable Care Act. That’s the highest rate of marketplace enrollment since it launched in 2013.
Insurers that offer plans through the state marketplace are seeking rate hikes for 2025, however, citing inflation, bigger claims and rising costs for drugs like Ozempic and other obesity treatments.
Where Harris, Democrats stand: Harris and fellow Democrats have continued to tout savings and protections under the Affordable Care Act and their work in tamping down drug costs.
Driven in large part by COVID-era policies, the numbers of uninsured Americans fell to the lowest point in history last year — to just more than 7% of the population. Of those, more than half are likely eligible for tax credits if they choose to get insurance, according to the Congressional Budget Office.
Related:
- Cheaper Medicare drugs bound for Michigan. By how much? It’s complicated
- In Obamacare health coverage, could — and should — Michigan go it alone?
As a senator, Harris voted against Trump’s attempts to repeal the Affordable Care Act. As vice president, she has supported enrollment period expansions and programs to reduce or eliminate premiums for low-income families as part of the Inflation Reduction Act of 2022.
That law also capped insulin prices for patients with Medicare drug coverage and required the federal government to negotiate prices with drug companies for certain medications covered under Medicare, which is expected to lower costs.
While Harris supported a universal Medicare-for-all system during her 2020 presidential campaign, she now says she wants to slowly grow the government-run program while “leaving room” for private insurance.
Harris has criticized Trump for his pledge to repeal the Affordable Care Act without proposing a viable alternative, citing his September debate comments that he has “concepts for a plan” but no concrete proposal.
“He’s going to threaten the health insurance of 45 million people in our country based on a concept,” Harris said in a recent Flint rally. “To take us back, you remember that, when insurance companies could deny people with preexisting conditions? Remember what that was like? Well Michigan, we are not going back.”
Where Trump, Republicans stand: Trump has repeatedly blasted the Affordable Care Act but he has not proposed a clear alternative. His campaign website states that he “will always protect Medicare, Social Security, and patients with pre-existing conditions” but does not include many details.
As president, Trump tried to repeal and replace the Affordable Care Act, but that effort narrowly failed in the U.S. Senate. He took administrative action to implement stricter Medicaid verification requirements for eligibility and proposed other restrictions to the program.
Although Trump remained critical of vaccine science and discouraged following many safety precautions during the COVID-19 pandemic, his administration oversaw the development and distribution of the COVID-19 vaccine in less than a year — far sooner than most experts had predicted.
In 2020, the Trump administration attempted to reduce drug costs by allowing more imported medications, but Canada largely blocked those efforts by adopting measures to prevent bulk exports. Trump has remained critical of drug prices but it hasn’t been a big part of his campaign like it was in 2016 and 2020.
Instead, Trump has attacked Harris over her past support of proposals to transition the U.S. to a government-run ‘Medicare for All’ health system, which he argues would reduce access to quality care for many Americans.
“She pledged to abolish private healthcare,” Trump said in a recent rally. “Some people want private healthcare because they don’t want to wait in line for six months and force everyone into socialist government-run healthcare, which is what you have to do. They wait online for months and months and they take a routine or a minor illness and they end up being terminally ill.”
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