The 2024 presidential and Senate elections have returned power to Republicans, raising big questions about the future of key health policies, including the Affordable Care Act, drug price negotiations and abortion.
While detailed health policy plans have yet to emerge, we’ve compiled our election reporting to help you understand what changes could be ahead in the next four years.
Learn more about where President-elect Donald Trump stands on critical health policy issues by exploring our expert interviews from across the ideological spectrum and in-depth analysis of the potential impact of these policies on access to reproductive care, health insurance coverage and the cost of prescription drugs.
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Dive Deeper Into the Issues
Affordable Care Act
The Affordable Care Act (ACA) has cut the uninsured rate by over half, helping nearly 45 million Americans access coverage through Medicaid expansion and subsidies. A large body of research shows states that have expanded their Medicaid programs under the ACA have seen improvements in their state finances, economies, and citizens’ health and financial security. Despite its positive impact, the ACA continues to face criticism from Republicans over issues like fraud, quality of coverage and rising premiums, fueling continued promises of reform.
Explore more of our ACA reporting below to learn about past Obamacare battles.
- The Latest Threat to the Affordable Care Act: ACA expert Nicholas Bagley breaks down the court ruling striking down the popular requirement for insurers to offer free preventive care services.
- When Politics and Policy Collide on the Obamacare Exchanges: A creative working paper examines how Obamacare’s political baggage has made health insurance more expensive.
- ‘The Ten Year War’ Over Obamacare (and the Battles Ahead): Reporter Jonathan Cohn says the battle over Obamacare offers lessons and clues as to where the party’s “unfinished crusade for universal coverage” may head next.
Further Reading
- Sen. Bill Cassidy Wrestles with a $500 Billion Health Care Problem (Tradeoffs, 3/18/2024)
- House Speaker Mike Johnson criticizes Obamacare and promises ‘massive reform’ if Trump wins (Sahil Kapur, NBC News, 10/29/2024)
- GOP senator eyes health care overhaul and extending Trump tax cuts in one big 2025 bill (Garrett Haake and Sahil Kapur, NBC News, 10/2/2024)
- Millions Could Lose Insurance Subsidies, Depending on the Election (Margot Sanger-Katz, New York Times, 9/30/2024)
- The $20 Billion ObamaCare Subsidy Fraud (Brian Blase, Wall Street Journal, 6/19/2024)
- The Politics of Health Care and the 2024 Election (Larry Levitt, KFF, 5/28/2024)
Drug Price Negotiations
The Biden-Harris Administration scored a historic win by giving Medicare the power to directly negotiate the prices of some of the most expensive prescription drugs. Federal health officials say when the first 10 negotiated prices take effect in 2026, patients and Medicare will save $7.5 billion all together.
However, some high-ranking Republicans want to repeal that authority, arguing that reducing drugmaker profits will shrink their incentive to develop the next blockbuster treatment. Several pharmaceutical companies have also sued the federal government, claiming that Medicare negotiating powers are unconstitutional.
Explore the stories below to learn more about the future of Medicare’s power to negotiate the price of some of the priciest medications and America’s drug industry as a whole.
- “Race to the Bottom”: A New Series from Tradeoffs on the Ailing Generic Drug Industry: Debuting Sept. 12, this three-part series examines the problems plaguing an industry that America now relies on to fill 9 out of every 10 prescriptions.
- What to Expect When Medicare and Pharma Finally Negotiate Drug Prices: We explain how Medicare’s historic price negotiations with drugmakers will work, and the impact they could have.
- High-Price Drugs Out of Reach for Many on Medicare: Bianca Frogner breaks down new research on the impact subsidies can have for people on Medicare trying to access lifesaving drugs.
Further reading
- Compare the Candidates on Health Care Policy (KFF, last updated 10/8/2024)
- Five Things to Know: Healthcare and the U.S. Election (Sarah Fiorini, Gallup, 9/30/2024)
- Health Care Reform and the 2024 U.S. Elections — Low Visibility, High Stakes (Jonathan Oberlander, NEJM, 9/28/2024)
- The Campaign Issue That Isn’t: Health Care Reform (Margot Sanger-Katz, New York Times, 9/13/2024)
- The $20 Billion ObamaCare Subsidy Fraud (Brian Blase, Wall Street Journal, 6/19/2024)
- The Politics of Health Care and the 2024 Election (Larry Levitt, KFF, 5/28/2024)
Reproductive Health
Nearly two-thirds of abortions in the U.S. are now so-called medication abortions, typically involving a regimen of two pills – mifepristone and misoprostol. In June, the U.S. Supreme Court dismissed an attempt by anti-abortion advocates to strike down the Food and Drug Administration’s long-standing approval of and expanded access to mifepristone. But, depending on the election, new leaders at the FDA could move to restrict (or further expand) access to medication abortion.
Explore more of Tradeoffs’ reporting on reproductive health care.
- BONUS: The Court’s Big Abortion Decisions Are Out. What Now?: We break down the Supreme Court’s recent abortion rulings with help from health reporter Shefali Luthra.
- A Closer Look at the Abortion Medication Mifepristone: What is the abortion drug at the center of a new legal maelstrom–and what happens if patients lose access to it?
- The Conservative Clash Over Abortion Bans: Republican lawmakers in at least seven states are pushing to make their state abortion bans less restrictive.
Further Reading
- Compare the Candidates on Health Care Policy (KFF, last updated 10/8/2024)
- Five Things to Know: Healthcare and the U.S. Election (Sarah Fiorini, Gallup, 9/30/2024)
- Health Care Reform and the 2024 U.S. Elections — Low Visibility, High Stakes (Jonathan Oberlander, NEJM, 9/28/2024)
- Harris says she would support ending the filibuster to bring back Roe v. Wade (Jason Breslow, NPR, 9/24/2024)
- Vance Is Right on Health Care (Brian Blase, National Review, 9/23/2024)
- Trump’s ever-shifting position on abortion, explained (as best as possible) (Li Zhou, Vox, 8/9/2024)
Trump’s Health Policy Record
In the lead-up to the 2020 election, our team released a series of episodes examining the goals and policies of the first Trump administration from a failed campaign to repeal and replace Obamacare to significantly expanding the number of companies who could opt out of the ACA mandate to cover contraception for employees.
Click on the stories below to read our coverage of Trump’s health policy positions from the 2020 election.
- Trump and the ACA
- Trump and Reproductive Health
- Trump and Medicaid
- Trump and Drug Prices
- Trump and COVID-19
