When Donald Trump famously declared that for health care, he “has concepts” of a plan, many Americans relying on the Affordable Care Act for insurance were not surprised — Trump’s previous stances have been similarly vague. Though he was thoroughly derided for these comments during the presidential debate, Americans may be underestimating what changes will occur depending on the administration that takes power this election.
For the 45 million Americans relying on the ACA, Trump’s presidency could bring about major change in the accessibility of affordable health care. JD Vance clarified former President Trump’s plan with the proposal to establish “high-risk pools” for sicker patients, which would essentially reinstate restrictions based on preexisting conditions and dismantle the ACA.
The act currently prevents insurance companies from denying or increasing premiums based on preexisting conditions, which include illnesses like diabetes, heart disease and cancer. With increasing rates of young people developing precancerous conditions, it is a broad and essential issue. However, they are a slippery slope by nature — anything can be considered a preexisting condition with enough data to back it up.
Vance’s proposal could reverse the equalizing impact of the ACA. Separating based on “high-risk pools,” especially without clear guidelines as cancer rates rise for young people, could jeopardize health care accessibility for many Americans.
The expansion of Medicare benefits to cover home care, vision and hearing services has become a hallmark Democratic proposal. Vice President Harris suggests supporting this expansion by using savings from negotiated drug prices — changing the benefits from short-term to including chronic care assistance and home health aids.
Expanding Medicare could ease the burden on the “sandwich generation,” who care for both children and aging parents. She has been transparent regarding her intentions for Medicare. While Harris’s proposal essentially extends benefits to essential services, Trump has not clarified this issue despite its importance. He has not explicitly stated his future plans regarding Medicare; but his historic stance is that an increase in costs is necessary.
During Trump’s presidency, he introduced four consecutive annual budgets that aimed to reduce Medicare spending. His vague stance regarding Medicare plans poses a significant risk to those depending on it for health care. Medicare provides vital service to 67 million people, who may use it for regular care, medication access and essential treatment. Without a clear plan, his ambiguity could lead to unsureness about accessing the treatment that many seniors and people with disabilities rely on.
The Dobbs decision, accredited to President Trump’s choice of Supreme Court justices, transformed health care and will be furthered by any legislation signed regarding abortion rights per state. Abortion is ranked as the top issue for one-eighth of voters. Vice President Harris has promised to sign any bill restoring abortion rights while President Trump has repeatedly stated that he intends to leave abortion rights to individual states, not taking an explicit stance on the issue.
However, leaving decisions to states has impacted overall health care quality in each. Many medical residents and providers are avoiding and leaving states with abortion bans, exacerbating physician shortages. The results of fewer providers could mean reduced prenatal care access, delays in emergency care and less access to in vitro fertilization care. Health care accessibility is a constant challenge and legislation regarding abortion rights has already caused strong ripple effects.
