Health care issues and policy took center stage at the vice-presidential debate on Tuesday evening between Republican nominee Sen. JD Vance and Democratic nominee Gov. Tim Walz.
Vance and Walz debated several health care topics, including insurance, drug prices, reproductive rights and the U.S. mental health crisis, sharing their stances and those of their respective running mates, former President Donald Trump and Vice President Kamala Harris.
“I think this was the first time where we saw substantial health policy conversations in this entire presidential election,” Dr. Stephen Patrick. professor and chair of the department of health policy and management at the Rollins School of Public Health at Emory University in Atlanta, told ABC News. “So, it was great to hear substantial questions around health policy discussed in last night’s debate.”
Here’s where the candidates stood on different health care issues:
Health care and the ACA
Walz aligned with Harris’ views, discussing strengthening the Affordable Care Act (ACA) and protecting those with preexisting conditions from being denied health care.
Meanwhile, Vance defended Trump’s remarks during the presidential debate last month about having “concepts of a plan” in regard to health care. Vance also said Trump “salvaged” the ACA, despite past comments from the former president that he wanted to replace it.
“I think that candidate Vance seemed to try to … revise a little bit about how Trump treated the Affordable Care Act and his views of the Affordable Care Act,” Dr. Dennis Scanlon, a distinguished professor of health policy and administration at Penn State, told ABC News. “So, for example, [saying Trump] saved the Affordable Care Act, kept it going, took a bad thing and improved it. I don’t believe that the record really supports that.”
Scanlon added that there’s been much less of a Republican party focus on repealing and replacing the ACA than was seen in 2016 and 2020, likely due to the ACA’s favorability among voters.
Lowering drug prices
Both candidates talked about drug prices and the need to lower them, but neither gave many details about how their running mates would do so, experts told ABC News.
Walz brought up the Biden-Harris administration policy to begin direct price negotiations on 10 widely-used drugs under Medicare, as well as the Inflation Reduction Act that helped cap out-of-pocket costs for insulin under Medicare at $35 a month.
Meanwhile, Vance discussed Trump’s 2019 executive order requiring all hospitals to make public any standard charges, payer-specific negotiated charges, the amount a hospital is willing to accept in cash, and the minimum and maximum negotiated charges.
Dr. Joel Cantor, a professor of public policy at Rutgers University, in New Jersey, said while transparency is important, it’s unclear how that might reduce drug prices.
“Transparency is good … but if you have a health plan that covers one drug in a class of drugs that you need, transparency doesn’t help you at all,” he told ABC News. “You may be able to use three different drugs but if only one’s in your employer’s plan, that’s it.”
Cantor also said that there’s early evidence that the Medicare drug price negotiation will help bring down costs, but it remains to be seen whether that will extend to people who are not yet enrolled in Medicare.
Reproductive rights
Walz has been a supporter of abortion rights and has been vocal about protecting access after the U.S. Supreme Court overruled Roe v. Wade in 2022.
During the debate, he blasted Trump for appointing judges to the Supreme Court that overruled Roe v. Wade, which gave states the responsibility of legislating reproductive rights.
“This is [a] basic human right. We have seen maternal mortality skyrocket in Texas, outpacing many other countries in the world,” Walz said. “This is about health care. In Minnesota, we are ranked first in health care for a reason. We trust women. We trust doctors.”
In the past, Vance has expressed support for a national abortion ban. However, during the debate, he said he did not support a national ban and that it was important to let individual states make their own abortion policies. He also expressed wanting the Republican party to earn back women’s trust on the issue by making it more affordable to have children.
“Senator Vance said that several times – devolve the issue to the states – which doesn’t at all satisfy people who are advocates for reproductive rights and women’s autonomy,” Cantor said. “Whereas the Harris-Walz [stance] is very much to codify Roe, which would bring them sort of minimum access standards nationwide. It’s just a very clear difference.”
“I find that the Harris-Walz position very clear, and the Trump-Vance position a little kind of trying to avoid the question,” he added.
Addressing mental health and gun violence
The discussion of the mental health crisis in the U.S. came up as the candidates debated gun violence.
Both candidates agreed that there is a mental health crisis, but Vance asserted that addressing mental health is a way to reduce gun violence. Walz pushed back on that notion, saying it stigmatizes mental health to associate it as a cause of gun violence.
Patrick, of the Rollins School of Public Health, said the U.S. needs to approach gun violence and the mental health crisis as two separate issues.
“We did see differences in an approach to firearm violence [during the debate] … Firearms and mental health are not the same thing,” Patrick said. “Why that’s important is we see stigma towards people with mental health diagnoses that they may become violent. We know that that’s not true. Most people with a mental health diagnosis are not violent, and so it’s important for us to separate these issues.”
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