WASHINGTON — Democrats set the stage this week for a convention filled with boasts about their most popular health care policy victories and lofty goals for the future.
The four-day event in Chicago comes as former President Donald Trump steps up attacks on rising inflation, economic hardship and border policies under Biden. Republican candidates have not mentioned health care much in campaign speeches, but Democrats see it as an issue they can win over voters on, from reproductive rights to lower drug prices.
Democratic presidential nominee Harris will speak on Thursday night, the same night Beyoncé is rumored to perform, before a flurry of high-profile Democrats are expected to appear in the days leading up to the speech, including running mate Tim Walz, the governor of Minnesota, and many of the “white guys” who were on Harris' shortlist.
Here are the key health care issues Democrats will likely emphasize:
Negotiated drug prices
The first set of Medicare-negotiated drug prices was released Thursday, providing a chance for Democratic National Convention speakers to talk about the Biden administration's efforts to lower drug costs and where Harris fits into that.
Already, Biden, Harris and other administration officials have highlighted the fact that the vice president cast the “deciding” vote to pass the Control Inflation Act, sweeping legislation that would allow Medicare to negotiate directly with pharmaceutical companies to lower prices for commonly used drugs.
Though the prices for the first 10 drugs won't go into effect until 2026, Harris has already begun planning to “speed up negotiations so that prices for more drugs come down faster,” according to the presidential platform her campaign released on Friday. Given that the IRA set the ground rules for the negotiating process and how it will expand over the next few years, it's unclear how Harris would implement it as president. But her plan echoes comments Biden made in his State of the Union address this year.
“Throughout my career, I have worked to hold bad actors accountable and lower prescription drug prices,” Harris told attendees at an event celebrating drug price negotiations in Maryland on Thursday. As California's attorney general, she joined a fraud lawsuit against GSK that resulted in the state receiving $3 billion in a settlement.
Questions remain about how much Medicare enrollees would save from negotiated-price plans. At the Democratic National Convention, Harris and other administration officials are expected to defend negotiated pricing, along with other relatively easy-to-understand aspects of IRAs, such as insulin price caps and out-of-pocket limits. In her platform, VP Harris promises that if elected, she would work to “cap insulin prices at $35 and prescription drug out-of-pocket costs at $2,000 for everyone, not just seniors.” That would require the cooperation of Congress and perhaps a runoff vote by VP Harris.
Right to Abortion
Harris and other Democrats have harshly criticized the Trump campaign over its messaging on reproductive rights, and this week was no exception. The issue gained momentum recently when Trump made comments at a press conference that seemed to leave open the possibility of restricting access to the abortion drug mifepristone, though the Trump campaign later denied the position and said Trump hadn't heard the question properly.
Trump's running mate, J.D. Vance, made things worse when CBS asked him to elaborate on his campaign's position on mifepristone, saying, “Obviously, you want to make sure that any medication is safe, that it's prescribed the right way, etc.” The remarks suggest that a future Trump administration could reintroduce restrictions on mail orders and enact other prescription barriers.
The comments were new ammunition for Harris' campaign, which has repeatedly invoked the conservative think tank's Project 2025 plan to argue that Trump would ban abortion nationwide. Trump himself has said he wants to leave the issue up to the states, but that message doesn't seem to be resonating with voters, who nationally polls show a majority of voters believe striking down Roe was a mistake.
The reproductive rights debate has also allowed Harris and her surrogates to speak directly about her cause: As vice president, Harris was the face of the administration's efforts to strengthen abortion rights and fight restrictions on mifepristone, and she was the first vice president to visit an abortion clinic.
Medical Debt
Harris aligned herself with the party's progressive wing with a new platform pledging to cancel billions of dollars in medical debt if elected president — a stance that goes far beyond Biden's plan announced months ago to remove medical debt from credit reports, and the American Rescue Plan relief package that canceled $7 billion in medical debt, though that's politically unfeasible.
The nation's total health care debt is estimated at more than $220 billion, though it's hard to gauge exactly how much the average American owes. Harris' campaign also offered few details about how her administration would cut billions of dollars in health care costs, though she said she would “work with states” on the plan.
“If you unfortunately get sick or injured, you shouldn't have to go bankrupt,” Harris and Walz said in a campaign statement.
The issue will resonate with voters listening to speeches at the Democratic National Convention this week, with 81 percent of voters saying medical debt relief is important, according to a recent poll.
Progressive groups have offered cautious support for the new plan.
The medical debt reduction proposal and efforts to accelerate price negotiations “are important first steps,” Joseph Gieverghese, executive director of the grassroots advocacy group Our Revolution, said in a statement, “but the progressive movement will be watching closely to ensure that these policies are not only enacted, but rigorously enforced to bring about the meaningful change the American people so desperately need.”
The fate of Obamacare
Democrats will also blast Trump for failing to fight Republicans' broad and widely popular push to repeal and replace the Affordable Care Act (ACA), a fight Harris agreed to in her policy platform released Friday, warning that Trump intends to revive and repeal the law that launched the ACA marketplaces, established coverage protections for pre-existing conditions and put in place mandatory insurance requirements.
Trump has said he won't renew the fight over repeal this year but wants to see the law improved. “I'm going to keep Obamacare unless there's a better way,” he said at a rally last week.
Public support for the Affordable Care Act has grown steadily amid the fight to repeal and replace it, according to Gallup, and a majority of voters support the law again this year, with many ranking it as a very important issue, according to KFF.
Biden, at an event in Maryland last week, previewed what will likely be an argument at the Democratic National Convention: “My predecessor and his MAGA friends in Congress tried to repeal Obamacare over 50 times,” he argued. “We stopped them.”
Medicaid
President Trump has promised to “not cut a penny” from Medicare and Social Security, reflecting the broad popularity of those programs and growing concerns about House Republicans' reform plans, which include raising the eligibility age.
But the former president has said little about what he plans to do about Medicaid in his second term, giving Democrats an opportunity this week to criticize his record. During his first administration, the Medicaid program allowed states to implement work requirements and considered issuing block grants that would review spending and cap federal funding.
Expanding Medicaid coverage is an issue many battleground Democrats see as a way to win voters' support. In North Carolina, a state that Harris and Trump have repeatedly backed, Gov. Roy Cooper, once Harris' final running mate, signed an expansion bill into law last year. Ten states, many of which vote Republican, oppose the measure.
State Medicaid enrollment has also changed dramatically over the past year, with some states losing millions of people covered after COVID-19 emergency orders were lifted, and ACA markets saw record enrollment at the time, though federal data this year show uninsured rates are rising again.
As chairman of the Democratic Governors Association, Walz, Harris' running mate for lieutenant governor, is poised to attack Republican-majority states and President Trump over Medicaid coverage.
“Extremist Republicans have blocked Medicaid expansion in our states and are still trying to gut the Affordable Care Act at the federal level, threatening the progress we've made,” he said in a governor's executive statement earlier this year, also pointing to Cooper's progress in North Carolina.
