With five weeks remaining until the election, Governor Tim Walz (D-MN) and Senator JD Vance (R-OH) participated in their first and only debate on October 1. This debate follows last month’s matchup between Vice President Kamala Harris and former President Donald Trump on September 10. The VP candidates addressed key healthcare issues, acknowledging the importance of healthcare access, lowering the cost of prescription drugs, and reducing the overall financial burden of healthcare on patients.

Sen. Vance elaborated on former President Trump’s healthcare policies, suggesting a model that differentiates between individuals with chronic illnesses and those who are healthier. This proposal has drawn attention because it could affect the Affordable Care Act’s (ACA) protections for individuals with pre-existing conditions. Gov. Walz emphasized concerns that such an approach could lead to higher premiums for those with pre-existing conditions, potentially reversing some of the advancements made since the ACA’s implementation.

Drug pricing was another topic of discussion during the debate, with Gov. Walz highlighting the Biden administration’s implementation of the Inflation Reduction Act (IRA). He emphasized that the IRA allows Medicare to negotiate drug prices, potentially lowering costs for consumers, and recognized the $35 copay cap for insulin as a positive step. In response, Sen. Vance claimed that drug prices increased less during Trump’s administration compared to the current administration.

The debate also addressed the topic of abortion and reproductive rights more broadly. Sen. Vance acknowledged the need for Republicans to build trust with voters regarding this issue. Gov. Walz expressed his support for reproductive rights and the restoration of Roe v. Wade. Mental health was also discussed in relation to gun violence. Sen. Vance pointed to the mental health crisis as a factor contributing to gun violence, particularly in urban areas, while Gov. Walz raised concerns about firearm-related suicides in rural regions.

Additional Details on Health Policy Proposals Emerge

Since the party conventions in August, both campaigns have provided more detail on their healthcare policy plans. Vice President Harris is expected to maintain and potentially expand policies from the Biden administration. Her platform outlines several key priorities, including:

1. Expand the ACA: Enhance the ACA by increasing funding for enrollment efforts and making the reduced contribution percentages for households receiving ACA premium tax credits permanent.
2. Lower Prescription Drug Costs: Build on the Biden administration’s efforts regarding the IRA, aiming to expand the scope of Medicare drug negotiations and apply the $35 insulin copay and $2,000 out-of-pocket cap to the commercial market.
3. Focus on Women’s Health: Restore federal abortion rights by codifying Roe v. Wade into law and improve access to maternal healthcare.

If elected again, former President Trump is likely draw upon and refine several healthcare policies pursued during his first term:

1. Repeal and Replace the ACA: This was a platform of former President Trump’s 2020 campaign, though specific details regarding a replacement plan have not been specified in this election cycle.
2. Augment the IRA’s Drug Pricing Provisions: A second Trump term could potentially revisit the “most favored nation” policy for Part B drugs which would link US drug reimbursement rates to international reference prices, aiming to lower costs by aligning with pricing in other countries.
3. Increase Price Transparency: Continue efforts initiated during his previous term to enhance price transparency in the healthcare marketplace and address issues related to surprise medical bills.

What’s Next

The October 1 Vice Presidential debate is likely to be the final debate of this election cycle. Vice President Harris has accepted an invitation for a second debate later in October, while former President Trump has declined.

With the scene set for the upcoming Congressional lame duck session, policymakers will need to address federal funding and various policy extenders by December 20. Stakeholders should begin preparing now for this end-of-year legislative activity and looking ahead to the new Congress and administration in January. For further insights on the election outlook and support from Avalere, please watch our recent webinar or connect with us directly.