In the final days of the presidential race, healthcare gains more attention

While issues such as the economy, consumer prices and immigration have commanded a great deal of attention in the presidential race, healthcare has made more headlines in the final countdown toward Election Day.

Kamala Harris and Donald Trump are making a final push in the remaining days before the 2024 election.

Kamala Harris and Donald Trump are making their last push before Election Day, and the Affordable Care Act is looming as a key issue in the race. Harris has repeatedly pledged to protect the Affordable Care Act and also warned that a Trump return to the White House would endanger the law.

Trump, who tried repeatedly to abolish the law in his first term in office, has changed some of his rhetoric in recent months, saying he wants to improve the law.

House Speaker Mike Johnson cast new concerns about the future of the Affordable Care Act during an appearance in Bethlehem, Pa. this week, first reported by NBC News.

“Healthcare reform’s going to be a big part of the agenda,” Johnson said. When asked if that meant no Obamacare, Johnson replied, “The ACA is so deeply ingrained, we need massive reform to make this work, and we got a lot of ideas on how to do that.”

In a later statement to NBC News, Johnson said, “I offered no such promise to end Obamacare, and in fact acknowledged that the policy is ‘deeply ingrained’ in our health care system.”

A Trump campaign spokesperson said afterward that Trump’s position is not to repeal Obamacare.

• Read more: The 2024 election and the implications for healthcare

Regardless, the Harris campaign renewed warnings that a Trump return to the White House would potentially lead to the elimination of the Affordable Care Act and protections to ensure Americans aren’t denied coverage for pre-existing conditions.

Harris referenced the Affordable Care Act in her speech outside the White House Tuesday.

“You will pay even more if Donald Trump finally gets his way and repeals the Affordable Care Act, which would throw millions of Americans off their health insurance, and take us back to when insurance companies had the power to deny people with pre-existing conditions,” Harris said. “Well, we are not going back.”

Trump’s change in tone on the Affordable Care Act has been a marked departure from his first run to the White House, when he made abolishing Obamacare a central part of his campaign. The late Sen. John McCain memorably cast a decisive vote to preserve the law during Trump’s first term.

During his only debate with Harris, Trump said he wanted to make the law better but didn’t offer details. When asked for specifics, Trump said he had “concepts of a plan.”

Affordable Care Act enrollment rose to more than 21 million people in 2024, a record, and nearly double the 11 million people participating in 2020, according to KFF. The enrollment period for the Affordable Care Act for 2025 begins Nov. 1.

The law has proven to be popular with Americans. More than 6 in 10 Americans have a favorable few of the Affordable Care Act, according to a KFF poll.

Larry Levitt, executive vice president for health policy at KFF, said he doesn’t expect the elimination of the Affordable Care Act, even if Trump wins.

“I think the ACA is very unlikely to be repealed at this point,” Levitt wrote in a post on X (formerly Twitter). “The important question is what ‘massive reform’ of the ACA, as House Speaker Johnson has suggested, would mean.”

Reproductive freedom

Harris continues pressing her promise to protect abortion rights and restore Roe v. Wade. The Supreme Court’s conservative majority voted to overturn Roe v. Wade in 2022, Over the past two years, a total of 22 states have enacted laws restricting abortion or banning it in almost all cases.

Harris reiterated her vow to protect reproductive rights during her speech in Washington Tuesday.

“I think we all know one does not have to abandon their faith or deeply held beliefs to simply agree the government should not be telling her what to do with her body, not the government,” Harris said. “And when Congress passes a bill to restore Reproductive Freedom nationwide, as President of the United States, I will proudly sign it into law.”

The Harris campaign has also pointed to the dilemma doctors are facing in providing emergency care in states that have banned or severely restricted abortions. Doctors have said some state laws aren’t clear on when doctors can intervene to help patients, even those that have been trying to have a baby but faced serious complications.

Tim Walz, the Democratic vice presidential nominee, referenced the difficulties women are having getting care in an appearance in Bucks County, Pa., a suburb of Philadelphia. And he cast the blame on Trump.

“Women turned away now, because of what he’s doing, from emergency rooms to get basic care, having miscarriages in parking lots,” Walz said Thursday.

Today, USA Today published a story on a Georgia woman who suffered a miscarriage but said doctors delayed her care, even though she was bleeding heavily and the fetus wouldn't survive, until it was clear her life was in danger.

The patient, Avery Davis Bell, told USA Today doctors performed surgery a day after she was admitted; she was 18 weeks pregnant and was eagerly looking forward to having her second child. Bell said doctors wanted to help but weren't clear on how they could intervene within Georgia's abortion law.

Trump has said the question of abortion should be left to the states to set their own policies. During the debate with Harris, he didn’t answer when asked if he’d sign legislation banning abortion nationwide.

RFK’s role

Robert F. Kennedy Jr. has drawn more scrutiny on his potential role in a new Trump administration.

During his rally at Madison Square Garden in New York Sunday, Trump said that he would allow Kennedy to “go wild on health.”

“I’m going to let him go wild on the food, I’m going to let him go wild on medicines,” Trump said.

At a rally in Nevada Thursday, Trump also said he would put Kennedy in charge of "women's health."

Healthcare leaders dread the prospect of Kennedy holding a meaningful role in public health policy, given his well-publicized anti-vaccine views. Kennedy said in a video call to supporters that Trump has “promised” him “control over the public health agencies,” ABC News reported.

Kennedy appeared on NewsNation and said Trump would give him a key role on health policy.

“President Trump has asked me to reorganize the federal health agencies, the agencies that have a portfolio that affects human health, which is CDC, NIH, FDA,” Kennedy told NewsNation.

The Harris campaign denounced the prospect of Kennedy crafting health policy.

In a post on X, Harris wrote, “Putting an anti-abortion conspiracy theorist in charge of our public health agencies says everything you need to know about how Donald Trump would govern.”

Jerome Adams, MD, who served as surgeon general under the Trump administration, warned of the ramifications of Kennedy playing a key role on federal health policy. Adams shared his concerns at the American Public Health Association conference this week, New York Times reporter Sheryl Gay Stolberg wrote on X.

"If RFK has a significant influence on the next administration, that could further erode people's willingness to get up to date with recommended vaccines, and I am worried about the impact that could have on our nation's health, on our nation's economy, on our global security,” Adams said.

Caring for seniors

In her speech outside the White House earlier this week, Harris also highlighted her plan for a new Medicare benefit, Medicare at Home, which is designed to help seniors stay in their homes.

Harris talked about the plight of the “sandwich generation” who are raising children and caring for aging parents.

She also referenced her own experience of caring for her mother.

“If you need home care and you don’t have some money to hire someone, you and your family need to deplete your savings to qualify for help,” Harris said. “That’s just not right. So, we’re going to change the approach and allow Medicare to cover the cost of home care so seniors can get the help and care they need in their own homes.”

The AARP estimates that 48 million Americans are caring for a loved one, and over half of those individuals are working. Two of three caregivers say they're struggling to balance work and their family responsibilities, according to an AARP report.