Deborah D. Gordon has spent her career trying to level the playing field for healthcare consumers. She is co-founder of Umbra Health Advocacy, a marketplace for patient advocacy services, and co-director of the Alliance of Professional Health Advocates, the premiere membership organization for independent advocates. She is the author of "The Health Care Consumer's Manifesto: How to Get the Most for Your Money," based on consumer research she conducted as a senior fellow in the Harvard Kennedy School's Mossavar-Rahmani Center for Business and Government. Deb previously spent more than two decades in healthcare leadership roles, including chief marketing officer for a Massachusetts health plan and CEO of a health technology company. Deb is an Aspen Institute Health Innovators Fellow, an Eisenhower Fellow and a Boston Business Journal 40-under-40 honoree. Her contributions have appeared in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, The Hill and Managed Care Magazine. She earned a BA in bioethics from Brown University and an MBA with distinction from Harvard Business School.
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Women’s health is on the ballot this November. Here’s what you need to know when you head to the voting booth about where each presidential candidate stands on key women’s health policy issues.
There’s a lot at stake in this presidential election, and women’s health policy will be impacted by our new commander in chief and their administration, no matter who wins. So, as the 2024 presidential election fast approaches, make sure you know where Kamala Harris and Donald Trump stand on important issues related to women’s health and healthcare.
You can do a deep dive on each candidate’s stances on their websites (do your research at KamalaHarris.com and DonaldJTrump.com) but here’s a quick snapshot of some of the key issues affecting the health of women and people assigned female at birth.
Kamala Harris wants to strengthen and expand the Affordable Care Act.
The Biden-Harris administration temporarily expanded eligibility and subsidies that lower premiums for people who buy insurance on the ACA Marketplaces through the American Rescue Plan Act (ARPA), and extended those subsidies in the Inflation Reduction Act (IRA). Kamala Harris proposes making the expanded ACA subsidies permanent.
Donald Trump wants to replace the ACA with "much better healthcare." During the debate, he mentioned that he has a "concept of a plan" for healthcare reform but has not issued specifics.
Trump campaigned in 2016 on repealing and replacing the ACA. Though that effort failed, his administration made other changes, including zeroing out the penalty for not having insurance, ending certain subsidies, and reducing funding for outreach and enrollment support.
Harris supports Medicaid expansion.
The Biden-Harris administration withdrew approval for states to require low-income people to work in exchange for Medicaid coverage and has encouraged continuous coverage.
Trump's platform makes no mention of Medicaid.
As President, Trump allowed states to require people to work in order to qualify for Medicaid. His failed efforts to repeal the ACA would have reversed Medicaid expansion. He also proposed restructuring Medicaid payments to the states using block grants or per person spending caps.
Harris has said she will protect Medicare by taxing millionaires and billionaires and closing tax loopholes.
As vice president, Harris cast the tie-breaking vote for the Inflation Reduction Act, which contained provisions to lower Medicare prescription prices.
The Harris-Biden administration expanded coverage for mental health services and extended coverage for telehealth through December 2024.
Trump has said he will make no cuts to Medicare and will not change the retirement age, although no specific policies have been shared.
As president, Trump enacted tax reductions that sped up the depletion of the Medicare Part A Trust Fund and repealed a federal board that was intended to slow Medicare spending. He increased Medicare premiums for higher-income beneficiaries. He also relaxed Medicare telehealth rules to make remote care more accessible during the Covid pandemic.
Harris supports a $6,000 tax credit for parents of newborns and enhanced child tax credits ($3,600 for children under 6 and $3,000 for older children).
Harris supports creating federal paid family and medical leave (the current Family and Medical Leave Act guarantees unpaid leave) and enhanced funding for childcare providers. She proposes a cap on childcare costs to no more than 7% of a family’s income.
Trump has not issued specific policy proposals, but at a New York Economic Club event, Trump stated that his proposals to increase tariffs on foreign imports would reduce the costs of childcare. He also said of childcare, “You have to have it.” Trump’s running mate, JD Vance, has said he supports a $5,000 child tax credit. A more modest proposal failed to pass in the Senate due to Republican opposition.
Harris has made a campaign commitment to pass the Equality Act, which protects LGBTQ+ people from discrimination.
The Biden-Harris administration reinstated Section 1557 of the ACA, which provides the broadest protections to date for healthcare based on gender identity and sexual orientation, for transgender people, and for gender-affirming care.
Trump has pledged to prohibit gender-affirming care for young people and block the use of federal funds for gender-affirming care.
Trump has also pledged to "Keep men out of women's sports" as part of the 2024 Republican pledge to "end left-wing gender insanity."
As president, Trump created the Division of Conscience and Religious Freedom at HHS and issued final conscience regulation expanded religious protections, which created opportunities for LGBTQ-based discrimination in certain circumstances.
Harris supports expanding the number of drugs that the government can negotiate and extending the $35 insulin cap for Medicare recipients to all Americans.
Harris cast the tie-breaking vote to pass the Inflation Reduction Act (IRA), which requires the government to negotiate drug prices on certain drugs, caps out-of-pocket drug costs and limits insulin costs to $35 per month for Medicare enrollees.
The Trump administration created a voluntary model for Medicare prescription plans to limit insulin costs to $35 per month and allowed states to import medicines from Canada; however that was later rescinded. Trump initially supported creating a “Most Favored Nation” status for Medicare to limit government spending on certain drugs but has since backed away from that position.
Harris advocates for federal reproductive freedom and supports a federal law to restore Roe v. Wade. She has pledged to sign legislation guaranteeing federal rights to abortion care.
Supports the FDA decision to approve mifepristone, a drug used for miscarriage and abortion care.
The Biden-Harris administration has issued executive orders reiterating federal protections for abortion care as part of the rules that ensure access to emergency care and reinforcing rules that require pharmacies to fulfill prescriptions for reproductive health services.
Trump has taken credit for the Supreme Court's decision to overturn Roe v. Wade, which removed the constitutional right to abortion. He favors letting states decide their own abortion laws, and he personally supports exceptions to abortion bans in cases of rape, incest, and threats to the mother's life.
Although Trump has held a variety of positions on abortion rights over the years. Recently, he said that laws banning abortion after six weeks go too far, but later stated that he plans to vote for such a measure in Florida, his home state. Trump previously would not commit to vetoing a federal abortion ban if Congress passes one, but more recently posted on social media that he would veto such a ban.
Harris supports the FDA decision to improve access to medication abortion pills by allowing them to be mailed.
The Biden-Harris administration opposes the interpretation and enforcement of the Comstock Act to prevent sending abortion medication through the mail.
Trump has suggested he would block availability of medication abortion pills at times and suggested that he would not block them at other times. Support for leaving abortion policy to the states allows states to block access to all abortion, including medication abortion pills.
Trump has not publicly spoken on his position on the Comstock Act, but many Republican leaders, including his running mate JD Vance, have called for the enforcement of the Comstock Act to prohibit the mailing of medication abortion pills.
Harris supports the proposed Right to Contraception Act, which protects the right to contraceptives.
The Biden-Harris administration is fighting a federal lawsuit that challenges ACA requirements to cover preventive services (including contraceptives). The administration has issued executive orders in support of contraception.
Earlier in the 2024 campaign, Trump said he was open to restrictions on contraceptives but later promised never to ban birth control.
Trump administration policies paved the way for employers with religious objections to exclude birth control from employee health plans. Most Republican members of Congress, including Vance, opposed the Right to Contraception Act.
Harris supports guaranteed rights to IVF and supports the ACA, which includes access to coverage before, during and after childbirth. She advocated against a ruling from the Alabama Supreme Court that embryos are children, and therefore cannot be destroyed.
She took a stand against Republicans blocking a bill that would have protected IVF.
Trump supports access to IVF and said he would require insurance companies to cover the costs but did not detail how he would implement such a requirement.
The Republican platform opposes research using embryonic stem cells (which can be derived from the IVF process).
The Biden-Harris administration has encouraged states to extend Medicaid eligibility to cover women during the postpartum period and to reduce maternal mortality.
As a Senator, Harris supported bills to improve pregnancy care and reduce racial and ethnic health inequities.
As president, Trump signed the Preventing Maternal Deaths Act of 2018 to fund maternal mortality review efforts. The administration implemented the Maternal Opioid Misuse model to support pregnant women with opioid use disorder.
In the past, Harris supported 12 weeks of paid leave for most workers, including new parents, caregivers and victims of intimate partner violence. During her presidential run, she has expressed support for paid family and medical leave but has not shared details.
As president, Trump signed the 2020 National Defense Authorization Act, which provides 12 weeks paid parental leave to federal employees for the birth or adoption of a child.
