This four-part series examines the candidates’ positions and policy proposals in an effort to cut through the noise and highlight where Kamala Harris and Donald Trump stand on critical issues facing Americans in this election. Information is sourced from campaign websites and what the candidates have said on the trail and in interviews.
Donald Trump and Kamala Harris have starkly different positions on health care and reproductive rights—perhaps most evident in their approach to abortion.
Improving health care for Americans has been a pressing issue for decades, with the pandemic shining a light on the dysfunction and inefficiencies of an antiquated system where about a third of all costs stem from bureaucratic and administrative expenses.
The U.S. spends twice as much on health care per capita compared to other wealthy nations, but ranks among the lowest in many important health indicators.
The Affordable Care Act was a noble effort to address some of these lingering problems and expand access to health care. The Committee to Protect Health Care PAC released a letter signed by 1,500 doctors calling on Trump, who pledged during his first run for the White House to “repeal and replace” the measure, to explain his health care plan and tell voters what he intends to do with the ACA if elected. As for Harris, she said during the presidential debate on Sept. 10 that she intends to strengthen the ACA.
Kamala Harris’ Health Care Plan
Harris’ health care proposals contain far more specifics than Trump’s, with a focus on expanding access and bringing down costs. The vice president has also made reproductive rights a core tenet of her campaign. She aims to restore access to abortion and establish protections for women across the country.
Establish paid family and medical leave
Harris pledges to revitalize Congress’ Family and Medical Leave Act (FMLA), which currently affords Americans 12 weeks off—unpaid. Harris has also spoken about the need to enact paid family leave and other forms of assistance. “Every worker should be able to take time off to care for themselves or for the people they love,” she said.
Invest in affordable child care
The vice president would limit the amount working families pay for child care to 7% of their income.
Expand Medicare to cover in-home care for the elderly and disabled
Harris states on her campaign website that she’ll “fight to lower care costs for American families, including by expanding high-quality home care services for seniors and people with disabilities.” Announcing her proposal during an appearance on “The View,” Harris said the measure is meant to help the so-called “sandwich generation”—those with children and parents to take care of at the same time. The policy aims to free up finances and time for caregivers who’ve historically had to leave their employers and lose income to care for elderly parents or disabled loved ones.
Sign national abortion protection into law
Harris pledges to sign a law reinstating Roe v. Wade and the federal right to abortion if Congress passes it. This would exceed any state law that bans or greatly restricts abortion access.
Lower prescription drug costs
She proposes lowering prescription drug costs by installing a $2,000 annual cap on out-of-pocket drug costs for those with private insurance.
Defend and expand the ACA
Harris advocates for keeping the ACA intact and expanding it. She has emphasized the importance of preserving the ACA by recalling Trump’s efforts to repeal it. The policy, implemented by President Barack Obama in 2010, provided insurance for more than 21 million Americans in 2024.
Donald Trump’s Health Care Plan
Trump’s health care plan hasn’t been fleshed out despite years of promises. His campaign website has little on the topic other than broad statements about increasing “transparency” and promoting “choice and competition.” The former president, who also takes great pride in claiming responsibility for the Supreme Court overturning Roe v. Wade, has admitted that he has just “concepts of a plan” for improving the American health care system.
Lack of proposals or vague answers on the ACA
In 2016, Trump campaigned on repealing and replacing the ACA. He failed while in office. Trump has continued his push to repeal the ACA and replace it with a plan he claims would be more affordable—without providing details. “I had a choice to make when I was president: do I save it and make it as good as it can be—never going to be great—or do I let it rot? I felt I had an obligation, even though, politically, it would have been good to just let it rot and let it go away,” Trump said at the Sept. 10 presidential debate.
Murky proposal on national abortion ban—”leave it to states”
As the president who nominated three Supreme Court justices responsible for overturning Roe v. Wade, Trump has expressed pride—and campaigned on—the decision. However, he has also said that he would veto a federal law banning abortion and believes individual states should decide the issue. Trump praised “the courage” of the justices for overturning the longstanding federal protection of abortion during an all-women town hall on Oct. 16, claiming that Americans wanted abortion “brought out of federal government and brought back to the states.”
End transgender care
Trump has made it a campaign issue to keep men out of women’s sports, ban taxpayer funding for gender reassignment surgeries, and stop schools from supporting gender transition.
Enlist his daughter to establish child care policy
“Child care is a No. 1 priority, and I have no choice because I have a daughter named Ivanka… and that’s all she talks to me about is child care for the people,” Trump said at the Oct. 16 town hall. “We put in a great child care and we’ll be expanding that, and that will help you a lot,” the former president told the all-women audience.
