Vice President Kamala Harris and former President Donald Trump represent different viewpoints on health care policy in America, albeit in the United States 2024 presidential electionHealth care hasn’t played as big a role in the election campaign as it did in 2016 or even in 2020. In those campaigns, leftists proposed a radical overhaul of Obamacare while Republicans tried to repeal it.

Harris has backed away from single-payer health care

During her 2020 presidential campaign, Harris’ position on the future of private health insurance was sometimes confusing. In a 2019 primary debate, Harris raised his hand when moderators asked candidates whether they would eliminate private health insurance. But shortly afterwards she said: No, she would not abolish private health insurance.

In April 2019, Harris co-sponsored Senator Bernie Sanders’ “Medicare for All” bill, which would have eliminated private health insurance and replaced it with a single government insurer for all Americans.

Harris released a health plan in 2019 that would have put the U.S. on a path to government-supported health insurance over 10 years, but would not eliminate private health insurance.

“We will allow private insurers to offer Medicare plans under this system that meet strict Medicare cost and benefit requirements,” Harris said at the time. “Medicare will set the rules for these plans, including price and quality, and private insurance companies will follow those rules, not the other way around.”

Trump often brings up Harris’s past support of “Medicare for All” on the campaign trail, accusing her of promising to “force everyone into socialist, government-run health care with high taxes and deadly wait times.”

Harris’ campaign has said she will not support universal health insurance if she becomes president.

“I absolutely support and have supported private health care options over the last four years as vice president, but what we need to do is maintain and expand the Affordable Care Act,” Harris said in her debate against Trump.

Trump says he has “concepts” for a healthcare plan

During the debate in Philadelphia, Trump said he would “replace” Obamacare, which Republicans in Congress have largely abandoned in recent years. Trump and a Republican Congress tried “repeal and replace” Obamacare in 2017 and failed.

“Obamacare has always been bad health care,” Trump said. “It’s not very good today. And what I said: If we think of something and work on it, we will do it and replace it.”

One of the moderators asked for a simple yes or no answer: Does he still not have a health insurance plan?

“I have concepts for a plan,” Trump said. “I’m not president right now, but if we come up with something, I would only change it if we come up with something that’s better and more cost-effective. And there are concepts and options that we have to do that, and you will do it. I will hear about it in the not too distant future.

At rallies, Harris has portrayed Trump’s attacks on the Affordable Care Act as a threat to some of the law’s most popular provisions, such as ensuring coverage for people with pre-existing conditions.

Trump has rejected these claims. As president, he repeatedly promised that GOP efforts to replace Obamacare on Capitol Hill would maintain protections for pre-existing conditions.

During his time as president, Trump has struggled to come up with a health care plan, sometimes saying he would come up with a plan in “two weeks.”

As president, Trump opposed Obamacare after its passage. tweet has called for the law’s repeal dozens of times, but the most promising attempt to repeal the law failed with the late Senator John McCain’s dramatic speech Thumbs downn vote in 2017.

Trump and Republicans have also tried to repeal or weaken the Affordable Care Act in other ways. In December 2020, during the coronavirus pandemicthe Trump administration the Supreme Court asked to overturn Obamacare. The filing came the same day the government reported that nearly half a million people who lost health insurance in the wake of the economic crisis had signed up for health insurance through HealthCare.gov.

In the case, Texas and other Republican-led states argued that the ACA was essentially declared unconstitutional after Congress passed the 2017 Trump tax cut, which eliminated unpopular fines for not having health insurance but retained the coverage requirement. The Supreme Court rejected the challenge.

In 2018, the Trump administration temporarily shut down exposed Risk Adjustment Payments to Insurers – Money used to fund insurers with sicker, higher-cost patients. In 2017, the Trump administration shortened the enrollment period and closed the federal health exchange for 12 hours almost every Sunday.

Harris wants to continue Biden’s crackdown on pharmaceutical companies

Harris called for an expansion of parts of the Inflation Reduction Act that target drug prices, in addition to calling for a “crackdown” on drug manufacturers and insurance “middlemen” who drive up costs.

Harris voted decisively in 2022 for the Inflation Reduction Act, which allows Medicare to negotiate drug prices for its more than 60 million members.

So far, the Biden administration has placed price caps on a range of drugs for Medicare patients, including Eliquis for blood clots, Entresto for heart failure and insulin. These will come into force in 2026.

Harris supports expanding legal caps on insulin prices and out-of-pocket costs beyond Medicare, as some in Congress have suggested. Harris also wants to expand the bargaining program so Medicare can set caps on more drugs more quickly.

Trump has also promised to lower drug prices, although his campaign recently distanced itself from a proposal he had floated: reviving a controversial attempt to tie Medicare prices to other countries, which was withdrawn in 2021 amid multiple legal challenges became.

Trump says he wants to mandate IVF coverage, but Republicans in Congress aren’t so enthusiastic

Trump has said he wants either the government to fund in vitro fertilization (IVF) or for private insurance companies to cover the cost of the expensive and intensive fertility procedure.

Infertility advocates have supported such proposals on Capitol Hill. A bill introduced by a handful of House Republicans over the summer would have required private health insurance to cover the procedure.

But Republicans on Capitol Hill don’t necessarily agree with Trump on mandating IVF insurance. IVF is an expensive procedure, costing between $12,000 and $24,000 per cycle. And many couples need multiple IVF cycles to conceive a child, as only about 36% of cycles result in a live birth using their own eggs for women ages 35 to 37. For women over 40 who use their own eggs, this percentage drops to 8% per cycle.

Senate Republicans have twice blocked legislation This would protect access to IVF and require insurance companies to cover fertility care, a vote that drew attention from Senate Democrats to Trump’s statements on fertility insurance. Only two Republicans — Sens. Susan Collins of Maine and Lisa Murkowski of Alaska — voted with Democrats for the bill.

“If Donald Trump and Republicans want to protect people’s right to access IVF, they can vote for it,” Senator Tammy Duckworth of Illinois, who sponsored the bill, told CBS News before the vote. “He has shown that just one sentence is enough for him and the Republican Party will join him.”

Senate Republicans have repeatedly expressed support for IVF and claimed Democrats’ legislation goes too far. Senators Ted Cruz of Texas and Katie Britt of Alabama introduced their own package to protect access to IVF this year, but Democrats rejected it and questioned its scope and enforcement measures.

Other Republicans, like former Gov. Nikki Haley, said access to IVF is a good thing, but coverage shouldn’t be mandated.

“Both of my children have had fertility treatments,” she said said CBS News“Face the Nation.” “We want this option to be available to everyone. But you do it in such a way that you don’t mandate insurance coverage. Instead, you make sure the coverage is accessible and you make sure you do everything you can to make it affordable.

More than a dozen states and Washington, DC already require that some private insurance plans cover IVF.

Kaia Hubbard and Alexander Tin contributed to this report.