August 7, 2024

By Grace Totman, Co-Head of Capstone’s Healthcare Practice

Capstone believes that while Vice President Harris’ views on healthcare closely align with those of President Biden, they diverge in Harris’ even greater deference to labor unions—if her recent campaign strategy is any indication—and increased focus on women’s health. Despite Harris’ past support for Medicare for All (M4A), albeit with a Medicare Advantage spin, we do not expect this to become a major priority.

What Harris Has Said About Healthcare Policy

• Prioritizing labor union interests: In the days since she announced her candidacy for the presidency, Harris has received a series of influential endorsements from major labor unions. Harris has long had strong ties to organized labor, even accused in 2017 by Prime Healthcare Services of abusing her position as California attorney general to act on behalf of the Service Employees International Union-United Healthcare Workers (SEIU-UHW), a major campaign contributor of hers. This support for labor unions has continued in her role as vice president. In April 2024, Harris spearheaded the release of pro-union rules setting minimum staffing requirements for long-term care facilities and at-home services. Capstone would expect this deference to labor unions to continue under a Harris presidency, and potentially even ramp up from Biden levels given Harris’ reliance on unions to try and advance a quickened campaign process.
• Women’s health: Harris has long been an advocate for women’s health and reproductive rights and played a major role in the Biden administration’s response to both the overturning of Roe v. Wade and the Alabama Supreme Court decision that disrupted the fertility industry earlier this year. We expect that Harris would continue this focus as president, using regulatory authority to push demo programs and enhanced Medicaid coverage. Harris may also look to increase fertility-related coverage mandates, benefitting the fertility industry.
• Medicare for All: During her 2019/2020 presidential campaign, Harris touted her plan for a Medicare for All option that resembled more of a Medicare Advantage for All. The plan would have provided a public health insurance option while also allowing private insurers to compete, although in a heavily regulated environment. While both parties at the time had criticized the plan for its 10-year transition timeline, it would be a far more industry-friendly version of the Medicare for All that insurers have come to fear. Capstone believes any form of single-payor health system, including Medicare for All, remains highly unlikely given the congressional environment and that Harris is unlikely to make this a key campaign topic to avoid appearing too left-leaning.
• Drug Pricing: Harris supported the Biden administration in rolling out the Inflation Reduction Act (IRA) and accompanying drug price negotiations. During her previous presidential campaign, she also proposed to limit payments for drugs with price increases that outpaced inflation. Like Biden, Harris also supported drug importation from comparable countries and proposed empowering Health and Human Services (HHS) to cap US drug prices at an international benchmark. Capstone would expect Harris to continue Biden’s victory lap on the IRA, and message for expansion of negotiation but likely fail to get any additional policies through.
• Telehealth: Harris was keen on expanding telehealth accessibility before the virtual care shift brought on by the pandemic. In 2018, she introduced legislation that would have enabled mental health services under Medicare through telehealth and exempted several individuals from coverage policies, such as originating site requirements. Capstone believes Harris would support broader telehealth reform in Congress, which already has bipartisan support as lawmakers seek to navigate post-pandemic telehealth flexibilities.

Where Harris Differs from Biden

Capstone does not expect Harris’ healthcare agenda to vary significantly from that of Biden. Harris’ comfortability talking about women’s health issues makes this a natural campaign talking point but her historical push for single payor healthcare feeds into the Republican camp idea that Harris is a radical left candidate, making it unlikely to become a key aspect of the campaign.

• Emphasis on Women’s Health: While both Biden and Harris broadly support women’s health and reproductive rights, Harris’ support is amplified and likely to be an integral component of her campaign. In May 2024, Harris became the first presidential or vice presidential candidate to visit a Planned Parenthood clinic. In 2022, she spearheaded the Biden administration’s Blueprint for Addressing the Maternal Health Crisis 2022. During her last campaign, Harris also suggested that states with a record of regulations to curb access to abortion would have to obtain clearance from the Department of Justice before enacting new laws relating to abortion, underscoring the potential for more legislation safeguarding abortion in the future.
• More liberal on health insurance: Harris has historically positioned herself further left on health insurance than Biden has. In 2020, Harris worked to forge a path between Biden’s appeal to moderates and the further-left campaigns of Sens. Elizabeth Warren (D-MA) and Bernie Sanders (I-VT). While Biden primarily advocated for an expanded role of the ACA, Harris took it further with her modified Medicare for All plan. Although it included a role for private health insurance, the plan also proposed expanding Medicare’s services to include vision care, dental care, hearing aids, mental health services, substance use disorder treatment, and comprehensive reproductive health care services, which drew significant opposition from private industry more broadly. Harris changed her tune once joining the Biden campaign, and Capstone expects her Medicare for All ambitions to remain largely tempered due to concerns of appearing too left-leaning.

Key Priorities for any Democratic Administration

If elected, Capstone believes Harris would continue much of the Biden healthcare agenda; pushing forward support for the Affordable Care Act (ACA) and touting the IRA drug pricing win.

• ACA: One of the biggest Biden wins in healthcare has been the record-low uninsured rate, which is partially attributable to the expansion of ACA subsidies and significant enrollment growth of the program. Harris is likely to continue “victory lapping” the exchanges.
• Drug Pricing Reform: Addressing prescription drug costs will remain a priority for any democratic administration. This would involve capping prices, increasing transparency, and curtailing fraud in the pharmaceutical and pharmacy industries.

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