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.

Further Reading

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. 

Further reading

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.

Further Reading

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. 


Dan is the Founder and Executive Editor of Tradeoffs, setting the vision for the organization’s journalism and strategy. Before Tradeoffs, he was the senior health care reporter at Marketplace and spent...