Healthcare continues to be one of the highest priorities for voters in 2024, consistently ranking as the second or third highest election issue.
The right to abortion is now the number one issue for women ages 18-44. The importance of healthcare to voters has become even more magnified given concerns over the economy and inflation. In fact, nearly 74% of U.S. adults are concerned about unexpected medical bills, making it one of the top financial worries.
Additionally 73% of adults are also worried about the general cost of healthcare services, highlighting the financial strain healthcare continues to place on Americans.
As women healthcare leaders working across the industry, we are working to support a multitude of healthcare issues that are seminal to this election:
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Reproductive Rights, including maternal and child healthcare
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Being able to offer affordable health insurance and prescriptions drugs, and;
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Preserving Medicare/Medicaid benefits to seniors and at-risk populations.
The Issues
Reproductive
Rights & Freedom
Affordable Health
Insurance & the ACA
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Protecting
Medicare & Medicaid
Reproductive Rights & Freedom
Background
Roe vs. Wade is the U.S. Supreme Court case that legalized abortion in the U.S. in 1973.
It rested on the fundamental right to privacy in matters of health, bodily autonomy, and family.
Because of this case, safe and legal abortion remained recognized as a federal constitutional right nationwide for 50 years.
The Courts
On June 24, 2022, the Supreme Court ruled on Dobbs vs Jackson Women’s Health Organization (a case involving a challenge to a Mississippi ban on abortion at 15 weeks of pregnancy).
This ruling overturned Roe, ending the federal constitutional right to abortion in the U.S.
As a result, 1 in 3 women now live in states where abortion is not accessible.
The Bans
Approximately 41 states have abortion bans in effect with only limited exceptions.
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14 states have a total abortion ban
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27 states have abortion bans based on gestational duration
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8 states ban abortion at or before 18 weeks’ gestation
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19 states ban abortion at some point after 18 weeks
Only 9 states and Washington D.C. do not restrict abortion based on gestational duration (Guttmacher Org).
The Results
The abortion bans have led to worsening health outcomes for women with studies showing that they are nearly three times more likely to die during or shortly after pregnancy in areas where access to abortion is restricted.
Disproportionality
These laws disproportionately harm Black, Latino, Indigenous, and other communities of color, where access to healthcare services is already limited.
Conclusion
The compounded effects of healthcare disparities and these restrictive laws exacerbate the challenges faced by these communities, further widening the gap in maternal and reproductive health outcomes.
Trump
Takes credit for overturning Roe v. Wade through his appointment of three conservative Supreme Court Justices. In the past, he has entertained the idea of endorsing a national abortion ban, but recently he appears to be wavering on that commitment. Mr. Trump supports state rights on abortion procedures but opposes any taxpayer funding for abortions. Publically, however, he has expressed support for a “NO” vote on the upcoming ballot measure in Florida this November, which seeks to establish a right to abortion in his home state.
Project 2025, an initiative led by conservative groups designed to guide the next Republican administration, proposes several significant restrictions on abortion.
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It aims to dismantle many of the Biden administration’s pro-abortion policies, including guidance requiring hospitals to provide abortion care when a pregnant person’s life is at risk. The project also seeks to reverse approval of abortion pills and enhance the CDC’s abortion surveillance to increase scrutiny and criminalization of those undergoing the procedure.
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While Project 2025 does not explicitly advocate for a national abortion ban, its policies would create severe restrictions and potentially lead to a de facto ban by limiting access to abortion pills and medical equipment.
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Additionally, it endorses the concept of "fetal personhood," where fetuses would be granted the same legal rights as children, a move that could end abortion at both state and federal levels.
Harris
Has been an outspoken defender of reproductive rights and has highlighted the harmful impacts of the Dobbs decision overturning Roe v. Wade. She advocates for protecting abortion access, including for travel, privacy, emergency care, and bodily autonomy.
She supports a federal law to restore Roe v. Wade’s national standard of abortion legality up to viability and she supports medication abortion pills, allowing dispensing via certified pharmacies and telehealth
She believes that abortion bans are putting women's health and lives at risk, disrupting access to critical health care services and undermining women’s equality and civil rights.
Abortion
Background
Before the Affordable Care Act (ACA) passed in March of 2020, coverage for prescription contraceptives was generally widespread in the private and public sectors, but not universal, and certainly not free of cost-sharing.
The ACA was the first law to set preventive coverage requirements for health insurance across all markets – individual, small group, large group and self-insured plans (KFF, State & Federal Contraceptive Coverage)
The Challenge
Currently, contraception remains legal in every state and is mandated to be offered at no cost by health insurers under federal law. However, in his concurring opinion during the Supreme Court’s 2022 decision to overturn Roe v. Wade, Justice Clarence Thomas suggested that the court might also reconsider Griswold v. Connecticut—the landmark 1965 ruling that established the constitutional right to access birth control.
This statement has sparked widespread concern among many voters, who fear that it could lead to future restrictions on contraceptive access and further curtail reproductive rights in the U.S.
Trump
Under his Presidential term, Trump prohibited family planning clinics that also offer abortion services from receiving funds from the federal Title X family planning program, leading to the disqualification or departure of approximately 1000 sites which also provide free contraception.
He also issued regulations allowing any employer with a religious or moral objection to opt out of the ACA’s contraceptive coverage mandate. The impact of these regulations has reduced access to contraceptives for many women. Employees whose employers claimed these exemptions were forced to pay out of pocket for contraception or find alternative insurance coverage.
The new exemptions particularly affected low-income women, women of color, and those working for religiously affiliated institutions. These groups faced higher barriers to obtaining affordable contraception, further widening healthcare disparities.
Harris
Supports the ACA and its contraceptive coverage requirement and defends legal challenges based on religion or moral objection (KFF, Litigation Challenges to ACA).
As VP, Harris helped restore rules of the federal Title X family planning program requiring participating entities to offer a full range of contraceptives, pregnancy options counseling, and re-allowing clinics that also offer abortion services (with non-federal funds) to qualify for the program (KFF, Rebuilding Tittle X).
Affordable Health Insurance & The ACA
Background
In March of 2010, President Obama passed the The Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare to reduce the number of uninsured Americans.
The ACA aimed to make health insurance more affordable by providing subsidies and expanding Medicaid through waivers in participating states.
The Impact
A record 21.3 million people enrolled in ACA plans in 2024, with a quarter being new enrollees.
Enrollment has been particularly high in red states, with increases of 80% in West Virginia, 75% in Louisiana, and 62% in Ohio, according to the Centers for Medicare & Medicaid Services.
Trump
In 2017, Trump attempted to repeal and replace the ACA with plans that would have increased the number of uninsured Americans to 51 million.
Although his repeal effort failed, he succeeded at eliminating the individual mandate penalty, which required people to have health insurance.
He also used executive actions to loosen some ACA regulations and endorsed litigation aiming to wipe out the law.
As recently as November 2023, he renewed his calls to replace the ACA, criticizing Republicans for not wanting to “terminate” it and vowed not to “give up.” More recently, in his current re-election bid, he has softened his rhetoric and says now, he would simply improve on the ACA.
Harris
The Biden-Harris administration passed the American Rescue Plan Act (ARPA), which temporarily expanded eligibility for and increased ACA Marketplace subsidies. These were extended by the Inflation Reduction Act (IRA) through 2025. This led to record-high ACA enrollment.
Harris has publicly announced never to dismantle the ACA which covers 21M people, the majority of whom are women.
Protecting Medicare & Medicaid Program & Benefits
Background
Experts predict that, at the r current rate of spending, Medicare will be insolvent by 2036 (Committee for a Responsible Federal Budget). Policy scholars have proposed various solutions to extend the solvency of the Medicare Part A Trust Fund, including raising taxes or increasing the eligibility age for seniors.
Current State
Medicaid, which is jointly funded by states and the federal government, has also been a topic of intense debate. Many states expanded their Medicaid programs using Medicaid Waivers under the ACA.
Contraception
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Trump
Aims to constrain Medicare costs by pushing for privatization, reducing payments to hospitals for outpatient care and cutting Medicaid spending.
He supported unsuccessful efforts to repeal and replace the ACA, including its Medicaid expansion, and proposed restructuring Medicaid into block grants or per capita caps. These proposals, part of his budget as President, were estimated to reduce federal Medicaid spending by roughly $1 trillion over 10 years.
Harris
Is committed to protecting Medicare for future generations. As VP, she cast the tie-breaking vote for the Inflation Reduction Act which allows Medicare to negotiate lower drug prices and caps insulin at $35 per month.
As VP, Harris worked to reverse Medicaid waivers approved under Trump that imposed work requirements, instead supporting waivers to expand coverage, reduce health disparities, address the social determinants of health, and help individuals transition out of incarceration.
The Biden-Harris Administration also did the following:
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COVID-19 Response: Increased funding and support for Medicaid and Medicare to address challenges arising from the COVID-19 pandemic, including providing additional resources for vaccine distribution and testing.
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Mental Health and Substance Use Services: Pushed for expanded mental health and substance use disorder services within Medicaid, including increased funding and support for community health programs.
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Home and Community-Based Services (HCBS): Advocated for increased funding for HCBS under Medicaid, aiming to improve services for individuals with disabilities and the elderly who prefer to live at home rather than in institutional settings.