Donald Trump and Kamala Harris outline their future plans for US healthcare

In the first presidential debate, healthcare emerged as a significant point of contention between former President Donald Trump and Vice President Kamala Harris, with both candidates outlining vastly different visions for the future of healthcare in the US. Trump said he plans to change the Affordable Care Act (ACA) if re-elected, while Harris defended the ACA.
In 2010, President Barack Obama signed the ACA into law, requiring most Americans to have health insurance and setting up state-run health insurance exchanges for those without employer-based coverage.
The ACA has provided health insurance to around 50 million Americans — about 1 in 7 people — over the past decade, according to the Treasury Department. In 2024, a record 21 million people enrolled in the ACA, including over 5 million new enrollees.
The law expanded Medicaid and provided subsidies to make healthcare more affordable. The Inflation Reduction Act of 2022 extended these subsidies to middle-income families, including those earning up to $103,280 for a family of three in 2024.
Donald Trump, the 78-year-old Republican presidential candidate, took aim at the Affordable Care Act (ACA), promising to replace it with a better system if re-elected. Trump also argued that Harris supports government-controlled insurance that leads to long wait times for operations.
“Obamacare was lousy healthcare. Always was. It’s not very good today,” Trump said during the debate.
He criticised the law for its high costs and inefficiencies, but he did not detail his plan of action.
When pressed by moderator Linsey Davis on whether he had a healthcare plan, Trump responded, “I have concepts of a plan,” adding that he would release “concepts and options… in the not-too-distant future”.
However, Trump has made similar promises before, notably during his 2016 campaign and presidency, but has yet to deliver a fully developed healthcare plan.
He reiterated his belief that “we could do much better than Obamacare” and said he would only eliminate the ACA if a superior system was devised.
In 2022, Trump on his social media platform, Truth Social, wrote, “I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!”
By the end of 2018, 13.7% of adults lacked health insurance, the highest percentage since 2014, according to Gallup data.
In December 2019, Trump issued an executive order requiring hospitals to publicly list their standard charges, including payer-specific negotiated rates, cash prices, and both minimum and maximum negotiated charges.
Trump’s latest proposal for a more affordable healthcare law might sound appealing, especially since US healthcare costs are rising faster than the economy.
According to NBC News, Americans spend about twice as much on healthcare as people in other countries.
Kamala Harris, the 59-year-old Democratic presidential candidate, on the other hand, staunchly defended the Affordable Care Act (ACA) during the debate, emphasising its importance in providing healthcare for millions of Americans, particularly those with pre-existing conditions.
“Access to healthcare should be a right and not just a privilege for those who can afford it,” Harris said.
She pointed out that Trump had tried to dismantle the ACA 60 times.
“You have no plan,” Harris told Trump. “And what the Affordable Care Act has done is eliminate the ability of insurance companies to deny people with pre-existing conditions. I don’t have to tell the people watching tonight. You remember what that was like? Remember when an insurance company could deny if a child had asthma, if someone was a breast cancer survivor, if a grandparent had diabetes? And, thankfully, as I’ve been vice president, we over the last four years have strengthened the Affordable Care Act.”
The Biden-Harris administration has allowed Medicare to negotiate drug prices for the first time. Harris’s platform includes expanding the $35 cap on insulin and the $2,000 annual cap on out-of-pocket prescription medication costs for seniors to all Americans.
Harris highlighted that ACA enrolment reached a record high in 2024, with 20.8 million Americans signing up for coverage.
“We have only strengthened the Affordable Care Act,” Harris said, pledging to further expand healthcare access and affordability if elected as president.