What's at Stake for Healthcare in the 2020 Election?

A lot hangs in the balance.

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Healthcare is one of the most complex topics in American politics, especially in the midst of a pandemic. It's a dense subject, but its implications can be severe: under the umbrella of healthcarewomen's rights can be put at risk, endemic racism and sexism can be amplified, and regular Americans can be forced into hundreds of thousands' worth of dollars worth of debt.

An over-simplification of how politics and healthcare intersect would say that the Democratic party tends to favor more healthcare coverage rather than less, and more government action to control costs and establish market equity; the Republican party, meanwhile, tends to favor privatized healthcare and less governmental oversight as a rule. Yet in the current landscape, which is politically divisive than ever in addition to enduring a pandemic, party lines are less clear.

Many Democrats argue that the issues on the table in 2020 are a matter of human rights, not of deductibles and copays. The Trump administration has issued healthcare-related policies and orders that have marginalized groups including women, LGBTQ+ individuals, and people and communities of color. Here's what's at stake for some of the most pressing healthcare topics today, and where both presidential tickets stand on them.


Trump and Pence: The current administration, which has overseen handling of the current pandemic, has leaned towards ignoring scientific sources and advice and existing pandemic infrastructure. It has offered contradictory views on wearing masks and touted unproven, potentially deadly remedies; Trump has also threatened to leave the World Health Organization.

Harris and Biden: Harris and Biden have a section of their website devoted to their coronavirus plan, which involves increased reliable testing and personal protective equipment (PPE) and re-setting up safeguards to mitigate COVID-19 impacts. Harris had proposed the COVID-19 Racial and Ethnic Disparities Task Force Act, which is designed to ensure that solutions are equitable for populations that see higher healthcare disparities and mortalities.

Healthcare Accessibility

Trump and Pence: The current administration repealed the individual mandate requiring people to have health insurance, and has fought the Affordable Care Act, which was enacted under the Obama and Biden administration. They have proposed re-allowing insurance companies the ability to discriminate based on medical history.

Harris and Pence: Biden was, of course, a part of establishing the ACA during the Obama administration, and supports its enhancement as well as improving the efficacy of Medicare. His plan may still leave gaps in coverage, and Harris and Biden initially clashed on this. Now that they're running mates, their newly released healthcare plan is a sort of hybrid, with a “Medicare-like” public option for consumers and an option for more affordable private insurance too.

Healthcare Equity

Trump and Pence: Progress has stalled on improving racial disparities in healthcare since the current administration took office. The President's claims of delivering results to reduce inequality for Black Americans have been debunked or unveiled as overblown.

Biden and Harris: Harris and Biden address healthcare for communities of color on their website. They say that their plan includes healthcare tax credits for impoverished people and expanding coverage to low-income Americans in particular. They also want to increase support for community health centers, particularly for underserved populations.

Women's Rights

Trump and Pence: In their American Health Care Act of 2017, Trump's administration attempted to repeal the ACA and remove basic care provisions for women (it didn't pass the Senate). The administration also threatened to repeal Roe vs. Wadeforced Planned Parenthood out of Title X funding, and was recently given the go-ahead by the Supreme Court to push forward with allowing employers to deny employees birth control coverage for religious or moral objections.

Biden and Harris: Biden has an Agenda for Women that, among other things, says it plans to "further women’s economic and physical security and ensure that women can fully exercise their civil rights." His views about women's rights have changed; although Harris challenged him on his perspective in the debates, both believe in repealing the Hyde Act, which blocks Medicaid from providing abortion services and disproportionately impacts people in lower income brackets and women of color.

Medical, Especially Pharmaceutical, Costs

Trump and Pence: The U.S. is one of the few developed nations without a "publicly accountable process" for pharmaceutical prices. Costs have risen as technology has improved, but there's no system to determine cost relative to value. The current administration has flip-flopped on the subject. A House "Pelosi Bill" has tried to tackle drug costs widely; it passed the House, but the Senate doesn't support it. A Senate Finance Committee Bill, which does less in terms of comprehensive change, was reintroduced in July.

Harris and Biden: Biden initially favored basing U.S. drug prices on costs in other nations that have limits on costs. On the Biden-Harris website, importing pharmaceuticals is listed as a part of their healthcare plan, as well as limiting price increases, forcing drug companies to negotiate with Medicare and limiting their tax breaks, and improving the supply of generic prescription drugs.

Other Healthcare Issues

In addition to these topics, other subjects will remain important for the election and beyond, including: mental health treatment, access to telehealth, addiction treatment, transgender rights, and long-term care as the U.S. sees a rise in aging baby boomers.

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Katherine J. Igoe
Contributing Editor

Katherine’s a contributing syndications editor at Marie Claire who covers fashion, culture, and lifestyle. In her role, she writes stories that are syndicated by MSN and other outlets. She’s been a full-time freelancer for over a decade and has had roles with Cosmopolitan (where she covered lifestyle, culture, and fashion SEO content) and Bustle (where she was their movies and culture writer). She has bylines in New York TimesParentsInStyle, Refinery29, and elsewhere. Her work has also been syndicated by ELLEHarper’s BazaarSeventeenGood Housekeeping, and Women’s Health, among others. In addition to her stories reaching millions of readers, content she's written and edited has qualified for a Bell Ringer Award and received a Communicator Award. 

Katherine has a BA in English and art history from the University of Notre Dame and an MA in art business from the Sotheby's Institute of Art (with a focus on marketing/communications). She covers a wide breadth of topics: she's written about how to find the very best petite jeanshow sustainable travel has found its footing on Instagram, and what it's like to be a professional advice-giver in the modern world. Her personal essays have run the gamut from learning to dress as a queer woman to navigating food allergies as a mom. She also has deep knowledge of SEO/EATT, affiliate revenue, commerce, and social media; she regularly edits the work of other writers. She speaks at writing-related events and podcasts about freelancing and journalism, mentors students and other new writers, and consults on coursework. Currently, Katherine lives in Boston with her husband and two kids, and you can follow her on Instagram. If you're wondering about her last name, it’s “I go to dinner,” not “Her huge ego,” but she responds to both.