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Trump and Pence: The current administration repealed the individual mandate requiring people to have health insurance, and has fought the Affordable Care Act, which was enacted under the Obama and Biden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

Katherine’s a Boston-based contributor at Marie Claire who covers fashion, culture, and lifestyle—from “Clueless” to Everlane to news about Lizzo. She’s been a freelancer for 11 years and has had roles with Cosmopolitan and Bustle, with bylines in Parents, Seventeen, and elsewhere. It’s “I go to dinner,” not “Her huge ego,” but she responds to both.