When he ran for office in 2016 and 2020, Donald Trump focused heavily on abortion, vowing to appoint Supreme Court justices who would overturn Roe v. Wade – what he did as president.
But this year, with Roe overturned, the 2024 GOP presidential candidate and the Republican Party have a new public health issue: transgender care.
While the GOP’s 2024 platform says little about abortion — and is a far cry from the proposed national abortion ban it called for in 2016 — it prioritizes limited access to gender-based care, which vow to «ban Taxpayer funding for sex reassignment surgery. , and ban Tax-Funded Schools from promoting gender reassignment.»
The focus on transgender issues is perhaps the most visible part of Trump’s health policy. On other bread-and-butter health policy issues, such as drug prices, insurance costs and health care for seniors, Trump largely echoes what the party has called: lower costs, transparency and increased access to care.
«Health issues are probably less prominent in this election than they have been in many times. But the impact of the election, the outcome of the election, will still have major implications for the direction of health care.» health,» said Larry Levitt, vice president of KFF, a health think tank.
The shift from abortion to transgender issues was spurred by the overturning of Roe, but also political reluctance for Republicans: Most Americans support federal protections for abortion, according to multiple polls, and voters supported abortion rights in all seven elections related to abortion. efforts since Roe was overturned — even in states where Republicans control the majority of state government.
That left gender equality as the GOP’s energizer issue this cycle.
Twenty-five states have taken action to restrict health care for transgender people, according to the Human Rights Campaign.
Trump has pledged to take a number of steps to reduce surveillance at the national level and has said that one day of his presidency he will issue an executive order directing all government agencies to stop programs that promote sex and gender change through any age.
Trump’s partner, Sen. JD Vance, R-Ohio, introduced a bill in July 2023 to make it a crime to give hormones or surgery to transgender children, punishable by up to 12 years in prison.
«The left-wing sexist madness being pushed on our children is an act of child abuse,» Trump said in a video posted on his campaign website.
In May of this year, the Biden administration rescinded Trump’s policy allowing health care providers to refuse to provide care to transgender people. That law is currently being challenged in the courts, and a second Trump administration is likely to reverse Biden’s move.
The 2024 Republican platform addresses «gender extremism,» and on the campaign trail Trump has often talked about banning transgender people from sports, eliminating any federal funding that goes toward gender equality and roll back Biden’s changes to Title IX education regulations. The platform also says the GOP will tax schools that participate in «equality education.»
«It’s become as much of a battleground as abortion has been in history,» Levitt said.
The price of drugs
As president, Trump caught public anger over the cost of drugs.
His administration created a demonstration program that reduced the cost of insulin to $35, passed a law tying Medicare reimbursement for certain drugs to the fees paid in other states and provided transparency rules for hospital prices.
He also proposed regulations for countries to import medicine from Canada – but Canada was not willing to participate.
The GOP’s 2024 platform calls for increased health care cost transparency and expanding choice, competition and access to prescription drug options.
«Any time you see a platform calling for more options, it’s usually a code word for less regulation,» Levitt said, referring to the Trump campaign’s drug pricing proposals.
It is unclear whether Trump, if elected, would implement the Biden administration’s 2022 Inflation Relief Act, and whether the Trump administration will continue with the federal government’s plans to negotiate drug prices. other prescriptions. Trump supported drug price negotiations during his 2016 campaign, but opposed Biden’s plan.
It may be difficult for the new administration to stop drug negotiations before the new prices take effect in 2026. However, the new Trump administration can negotiate the next prices to be closer to which insurers are already paying, so there would be little impact in later years. .
«He wasn’t on medication, and I didn’t expect him to be,» said Rodney Whitlock, a health consultant with McDermott + Consulting and a former Republican congressional staffer, Trump said. «I keep my expectations low for anything good for pharma in this system.»
Abortion
The Trump campaign has made a concerted effort to distance itself from Project 2025, a lengthy document outlining what a group of elite groups would like to see the Republican president do by 2025.
Part of the Health and Human Services plan, written by Trump’s former HHS Director for Human Rights, Roger Severino, repeatedly says the government should not treat abortion as health care and calls for several policies to reduce access to abortion, including revoking abortion consent and removal. the morning-after pill from a contraceptive prescription.
The Heritage Foundation, the main architect of Project 2025, declined to comment for this story and emphasized that Project 2025 is not about any candidate or campaign.
Trump, in an interview that aired Monday on Fox News, criticized Project 25’s abortion-related priorities as «going too far.»
«Really, people are voting … freely,» Trump said, pointing to ballot initiatives in Ohio and Kansas that did not favor including anti-abortion language in state law. «They can vote the way they want. It is not a federal issue. It will no longer be a federal issue.
If re-elected, Trump is expected to restore or expand several executive actions related to abortion and family planning. Trump has been widely praised by anti-abortion advocates for his attention to the issue during his tenure and has claimed responsibility for the Supreme Court’s overturning decision. Roe v. Wade.
Public health and pandemic preparedness
One of Trump’s most significant accomplishments during his presidency is one he often refuses to take credit for: research and development of a vaccine for COVID-19.
While Operation Warp Speed, a public-private partnership to develop a vaccine for COVID-19, remains one of the health policy successes of his presidency, the Republican establishment is quick to dismiss it. aside the importance of guns and Trump’s role in their development and proliferation.
On the campaign trail, Trump repeatedly vowed to cut funding to schools with COVID-19 vaccine needs. But all public schools in all 50 states require childhood immunizations as a condition of enrollment, and many colleges also have immunization requirements.
The 2024 Republican platform does not address vaccination regulations. Plan 2025 does just that, calling on the Trump administration to stop enforcing the Biden administration’s mandate of the COVID-19 vaccine for Medicaid and Medicare hospitals and to refuse to impose the mandate of the COVID-19 mask on nursing homes. life.
Severino also calls for removing vaccine mandates from the Head Start program and allowing more accommodations for individuals, including doctors, who cannot administer or administer vaccines because of religious beliefs.
Trump’s priorities may depend on who he chooses for his Cabinet.
For example, former HHS Secretary Alex Azar was given the latitude to move forward with regulatory policy without input from the White House, particularly on PBM discounts.
«The staff will decide what we end up seeing here,» Whitlock said.
This report has been prepared to reflect the implementation period of the 2022 drug negotiations law.
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