Editor’s Note: The John A. Hartford Foundation is collaborating with ASA RISE to advance equity through a series of blog posts in support of the development and dissemination of equity-related, partnership-based thought leadership through ASA’s Generation platform. This blog post is part of that series.
ASA RISE is a 20-week social justice and leadership program for rising leaders of color in aging. The John A. Hartford Foundation, the Archstone Foundation and RRF Foundation for Aging co-fund the program.
Following the Republican National Convention in July and the Democratic National Convention in August, many Americans heading to the polls are still seeking to better understand the parties’ policy platforms. While the campaigns work on shoring up and communicating their positions, one important question remains: how will the outcome of the election impact health equity?
Where Do the Parties Stand?
Republicans have been relatively quiet on the issue of health equity in this election cycle. Though the official former President Donald Trump–Sen. J.D. Vance policy platform does not mention health equity, it does call for the reduction of healthcare costs and expresses support for an increased focus on chronic disease prevention and management, and long-term care.
Project 2025, a conservative blueprint for the next Republican President, published by the Conservative think tank The Heritage Foundation, calls for significant cuts to Medicaid, imposing work requirements to receive Medicaid coverage, and making Medicare Advantage (Medicare Part C), the default Medicare program for older adults. It is important to note that the Trump campaign has repeatedly disavowed Project 2025, though the blueprint may still be a roadmap for federal and state policymakers.
‘Democrats have woven healthcare and health equity throughout their pitch to American voters.’
Democrats, on the other hand, have woven healthcare and health equity throughout their pitch to American voters. Despite a truncated campaign after a historic shake-up at the top of the ticket, Vice President Kamala Harris and Gov. Tim Walz continue to outline their healthcare priorities, which include expanding coverage, lowering costs, and protecting access to care.
Although we can expect Vice President Harris to shape her Administration’s priorities, we can look to the Biden Administration’s emphasis on health equity as a fundamental roadmap for a potential Harris Administration. That said, the Harris Administration will likely continue the Biden Administration’s Framework for Health Equity 2022–2032—a roadmap outlining plans for increased funding, research, and action to close health equity gaps for various conditions.
The Importance of Congressional Power
Despite a White House victory, a Trump or Harris Administration will still be beholden to Congress to achieve large parts of their agendas. With all seats in the House of Representatives on the ballot box and 34 Senate seats up for grabs, it is important to consider the impact a shift in Congressional power could have on health equity.
Here are a few possible scenarios:
One Party controls the White House and the other controls the House of Representatives and/or the Senate
- A split Congress, regardless of who controls the White House, will severely limit the opportunities for bipartisanship on any healthcare issue. Healthcare legislation during the 119th Congress (2025–2027) will be limited to areas of bipartisanship on specific issues that require legislative action in a timely manner, i.e., expiring provisions of the Affordable Care Act or funding of other healthcare-related government programs. In a split Congress, the Trump or Harris Administration will have to lean heavily on the powers provided to the Department of Health and Human Services to implement their healthcare priorities, leaving little room for massive overhauls of the system.
One Party Controls the White House, the House of Representatives and the Senate
- If Democrats maintain control of the White House and the Senate, while gaining control of the House of Representatives, health equity will be thrust into the legislative spotlight, and a tangible path to becoming law, for the first time since the “super majority” days of the Obama Administration. However, the margin of victory in the House and Senate may lead to a less-ambitious healthcare platform focused on opportunities for bipartisanship (i.e. rising drug costs, healthcare transparency, and telehealth/Artificial Intelligence, etc.)
- If Republicans win the White House and the Senate while maintaining the House of Representatives, health equity will likely remain a non-priority, taking a back seat to other issues that seek to unite the Party.
What Now?
As we barrel toward election day, we can expect former President Trump, Sen. Vance, Vice President Harris, and Gov. Walz to further cement and communicate their policy priorities on a range of issues important to Americans, including healthcare and health equity. Stay informed and up-to-date on issues and make sure you know where each party and its leadership stand on what matters most to you.
Ryann Hill, MPH, is the CEO and founder of Indigo Hill Strategies, a boutique government affairs and public policy firm in Washington, DC, and an ASA RISE alum. Interested in working together? Email Ryann at Ryann@IndigoHillStrategies.com.
Photo credit: Shutterstock/Svet foto
