The 2024 presidential election is just weeks away, and health care is expected to be a key issue for voters heading to the polls.
Overall health care costs remain a major issue. Health spending in 2022 increased by 4.1% to reach $4.5 trillion, accounting for 17.3% of U.S. GDP.
Rising costs highlight the core of America's health care conundrum. The United States spends more on health care than any other developed country in the world, at an estimated $13,493 per person. However, it lags behind in overall health performance, access and affordability, administrative efficiency, equity, and health outcomes, according to the Commonwealth Fund.
“Health care costs have always been a pain in the wallet for Americans,” Paul Schaefer, an assistant professor in the Boston University School of Health Law, Policy, and Management, told Yahoo Finance.
In recent weeks, Vice President Kamala Harris and former President Donald Trump's campaigns have heightened health concerns. President Trump's proposal is light on details but focuses on health care costs by promising to tackle insurance premiums, increase price transparency and reduce surprise bills.
Read more: What the 2024 campaign means for your wallet: Yahoo Finance's presidential election guide
Meanwhile, Harris would extend enhanced subsidies in the Affordable Care Act markets, cap insulin costs for all Medicare beneficiaries, not just seniors, cancel medical debt, and expand Medicare into long-term care. promised to expand to cover
Here we will summarize some of the health care issues facing Americans, how they relate to the presidential election, and the stances of each camp on these issues.
medical debt
An estimated 20 million Americans have a combined $220 billion in medical debt, according to the Peterson-KFF Health System Tracker.
In June, the Consumer Financial Protection Bureau announced that it would use funds from the American Rescue Plan to erase medical debt from credit reports.
In her economic plan, Harris said her administration would “help states enter into agreements with hospitals and other health care providers to reduce medical debt for more Americans and prevent future debt accumulation. We will support the formulation of the plan.”
President Trump has shown no plans to address the issue.
According to a KFF study, 35% of insured adults with medical debt said they had not filled a prescription for a medication due to cost in the past 12 months (compared to insured adults with no medical debt). (compared with 7% of patients), and 41% did not go to the hospital. Visiting a doctor or clinic if you have a medical problem due to costs (compared to 9% if you have no medical debt).
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Wendell Potter, a former Cigna executive and current director of the Center for Health Democracy, said high copays and other barriers make it difficult for people with insurance to get the care they need. did.
“It's one thing and laudable that 91 to 92 percent of Americans are insured,” Potter said. “There are still millions of people who are uninsured, but medical debt is “The majority of people with this condition have insurance.”
High out-of-pocket costs
Average annual premiums in 2024 were $1,368 for single coverage and $6,296 for family coverage.
For workers with single coverage in a plan with an annual deductible (the amount a consumer pays for covered medical services before coverage is applied), the average annual deductible is $1,787 . Meanwhile, the family deductible ranges from $1,548 to $4,991, depending on the plan structure.
During his time in office, President Trump signed executive orders requiring hospitals to disclose prices in a consumer-friendly format and requiring insurance companies to show Americans out-of-pocket costs for non-emergency services through online tools.
In addition to high out-of-pocket costs, other insurance practices can increase costs, such as prior authorization, which requires a health care provider's approval for certain prescriptions and services.
A Commonwealth Fund survey conducted in August 2024 found that 55% of respondents aged 19 to 64 disputed a bill for a service they thought should be free or covered by health insurance. I reported that there was no.
Potter said insurance companies “take a long time” because they know consumers often give up or doctors don't focus on specific patients because they have many other prior authorizations. “It's built into the system.”
“Due to various interventions by insurance companies, it is becoming increasingly difficult for doctors to see and treat patients,” he said.
Affordable Medical Care Act
President Trump has vowed to repeal the Affordable Care Act (ACA), commonly known as Obamacare, and replace it with something else. But during his last term, he and the Republican Party led multiple failed attempts to do so.
Meanwhile, Harris has promised to permanently expand enhanced subsidies granted through the ACA, with the Centers for Medicare and Medicaid Services saying most consumers could save at least $800 a year on their premiums. are.
Gideon Lukens, senior fellow and research director at the Center on Budget and Policy Priorities, told Yahoo Finance that the surge in marketplace enrollments since 2020 can be attributed to these “improved affordability.” He said that he has a high level of sexuality.
Lukens said policymakers “need to recognize” that extensions to these tax credits “need to happen as soon as possible” to prevent premiums from skyrocketing.
“I don't think everyone realizes the urgency of expanding the premium tax credit,” he said.
Medicaid expansion
Medicaid expansion has been an ongoing issue since the enactment of the ACA.
In 2012, the Supreme Court ruled that it was up to each state to decide whether to adopt the ACA expansion, creating a “coverage gap” in the 10 states that had not yet expanded Medicaid. This equates to approximately 2 million people without health insurance.
A 2023 study published in Health Affairs found that states that adopted Medicaid expansion were able to reduce uninsured rates and narrow racial and ethnic disparities in coverage. It turns out.
As of the first quarter of 2024, the current uninsured rate at the national level is 8.2%, or approximately 27.1 million people. By race/ethnicity, uninsured rates vary widely: 26% for Hispanics/Latino Americans, 9.8% for Black Americans, 7.7% for White Americans, and 5.1% for Asian Americans. There is.
“Expanding coverage through enhanced premium tax credits has not only increased coverage overall, but also reduced disparities and inequities,” Lukens said.
abortion
Another issue that is a “top priority” for many voters is reproductive health, said Schaefer, a professor at Boston University.
“Vice President Harris wants to restore Roe through legislation, but former President Trump failed to deliver on his promise to veto a nationwide abortion ban in his first decade,” he said.
Harris is a strong supporter of abortion rights, especially after Roe v. Wade was overturned by the Supreme Court in 2022. Her campaign website states that as president, “she will never allow a national anti-abortion law to become law.” If we pass a bill that restores reproductive freedom nationwide, she will sign it. ”
The Trump administration took several steps during his presidency to restrict access to abortion, including cutting federal funding from health centers that refer abortion patients. President Trump also appointed three Supreme Court justices, all of whom voted to overturn Roe v. Wade, a decision that Trump praises and even takes credit for.
As a candidate, Trump is trying to take a different tone on abortion. When Florida's ban on abortion after six weeks of pregnancy went into effect in early 2024, President Trump criticized the law but also opposed a state ballot measure to codify abortion rights in the state. . He has been vocal in his support for IVF, despite attempts by members of his own party to restrict access.
Earlier this year, he posted a video on his Truth Social platform saying, “My view is that abortions are happening where everyone wants them from a legal perspective. “Both, and the state, will decide whatever they decide.” In this case, it must be the law of the country. After all, this all comes down to following one's heart, or often one's religion, or faith. Do what is right for your family and do what is right for you. ”
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Adriana Belmonte is a reporter and editor covering politics and health policy at Yahoo Finance. X You can follow her at @adrianambells and contact her at adriana@yahoofinance.com.
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