Marcelo Leal/Unsplash

During the COVID-19 pandemic, healthcare systems faced an unprecedented surge of hospitalizations. Both the toll and stress of the pandemic have contributed to the erosion of public confidence in American healthcare. More than a third of Americans believe that their healthcare system is below average worldwide while around half of U.S. adults state that they have trouble affording high medical costs. 

In terms of policy, 53% of Americans say it is the responsibility of the federal government to make sure all Americans have healthcare coverage, though this has declined from 60% in September 2018.

Republicans and Democrats are sharply divided on this though — 81% of Democrats believe it is the responsibility of the federal government, while 77% of Republicans believe the federal government does not have this responsibility. Americans are also divided over how health insurance should be provided. 27% of Americans support a single national program, whereas 24% believe it should be provided through a mix of private and public programs. Those who say the government is not responsible for healthcare mostly want to keep Medicare and Medicaid, with only 6% wanting no government involvement at all.


The Candidates on the Affordable Care Act

Joe Biden (D): Supports the Affordable Care Act.

As president, he strengthened the Affordable Care Act by increasing marketplace subsidies for health insurance. He also approves an individual mandate for Americans to obtain healthcare, meaning most people who do not sign up for health insurance would face a financial penalty.

Dean Phillips (D): Supports the Affordable Care Act.

His first campaign for the House of Representatives focused on defending the Affordable Care Act. He now believes that the ACA must be expanded and the individual mandate should be reinstated. 

Nikki Haley (R): Opposes the Affordable Care Act.

She opposes the Affordable Care Act and has rejected efforts as governor of South Carolina to expand Medicaid under it; South Carolina remains one of 11 states that hasn’t expanded Medicaid.

Donald Trump (R): Opposes the Affordable Care Act.

Though he once supported a repeal of the Affordable Care Act, during his presidency, he shifted to rebranding or revamping it. He signed a 2017 GOP-backed tax law that removed the individual mandate, but kept most of the bill intact. He also signed an executive order to cover Americans with pre-existing conditions and expanded health reimbursement arrangements, setting aside money for people to spend on health insurance. He has recently stated that he will look for “alternatives” to the Affordable Care Act, reviving his past promise to repeal it.

Cornel West (Ind.): Not enough information.

RFK Jr. (Ind.): Not enough information.

The Candidates on Medicare

Joe Biden (D): Against Medicare for All, but supports the expansion of Medicare.

He signed the Inflation Reduction Act into law which gave Medicare the ability to negotiate lower prescription drug prices for ten drugs. He introduced a Medicare-like public option for individuals and families, expanding healthcare coverage. He also lowered the Medicare eligibility age to 60 years old. However, he is against “Medicare for All” and has suggested that he would veto it, instead advocating to strengthen existing healthcare systems.

Dean Phillips (D): Against Medicare for All, but supports the expansion of Medicare.

Though he wants all Americans to be insured, he does not believe in the elimination of private insurance or a government-only plan. Instead, he believes additional programs could ensure universal coverage.

Nikki Haley (R): Opposes the expansion of Medicare.

She opposes the expansion of Medicare and wants to change or potentially cut entitlement programs for younger generations, including Medicare. She supports expanding privately-administered Medicare Advantage plans, which cover about half of Medicare beneficiaries. 

Donald Trump (R): Supports Medicare.

He wants to improve Medicare by uprooting fraud, waste, and abuse. He has warned his party that “under no circumstances should Republicans vote to cut a single penny from Medicare or Social Security.” However, he is against Medicare for All. During his presidency, he moved to privatize parts of Medicare, allowing private companies to participate in Medicare in what is known as a direct contracting model.

Cornel West (Ind.): Supports going beyond Medicare for All.

He hopes to “go beyond Medicare for All,” but his alternative remains unclear. 

RFK Jr. (Ind.): Not enough information.

The Candidates on Prescription Drugs

Joe Biden (D): 

He has advocated to cut the cost of prescription drugs, specifically insulin, hoping to cap the cost at $35 per month. He has also focused on eliminating hidden junk fees in prescription drug costs: “If finalized, the rule would limit so-called “short-term” plans to… establish a clear disclosure for consumers of the limits of these plans.”

Dean Phillips (D): 

As Representative, he voted to reduce prescription drug prices by allowing generic drugs to enter the market earlier. He also introduced a bill to require allergen labeling in medication.

Nikki Haley (R):

As governor, she created a drug abuse advisory council to improve access to treatment. 

Donald Trump (R):

He signed an executive order requiring healthcare price transparency on prescription drugs. He also cut down FDA restraints on drug developments to increase generic drugs in the market.

Cornel West (Ind.):

He hopes to nationalize the pharmaceutical industry to control prescription drug prices.

RFK Jr. (Ind.): Not enough information.

The Candidates on Gender-Affirming Care

Joe Biden (D): Supports gender-affirming care for minors.

He is against the discrimination of transgender individuals in healthcare and reversed a Trump-era policy that limited “sex” discrimination protections at federally-funded healthcare providers solely to biological sex. He signed an executive order increasing access to gender-affirming care for minors.

Dean Phillips (D): Not enough information.

Nikki Haley (R): Against gender-affirming care for minors.

She hopes to increase access to healthcare for veterans, including a comprehensive review of the Veterans Affairs and increased telehealth options. She advocates for a ban on gender-affirming care for minors.

Donald Trump (R): Against gender-affirming care for minors.

He is against “the promotion” of gender transitioning for people of all ages.

Cornel West (Ind.): Supports gender-affirming care for minors.

He hopes to remove transgender discrimination from healthcare policies and establish a Health Bill of Rights for disabled people.

RFK Jr. (Ind.): Not enough information.

Candidates Who Have Dropped Out

Affordable Care Act


Marianne Williamson (D): Against the Affordable Care Act; supports a more comprehensive healthcare system.

She is against the ACA and instead calls for a complete revamp of the healthcare system. Under her "Whole Health System," she supports a long-term healthcare expansion plan, expanded patient knowledge of treatment options, and more frequent drug price negotiations. 

Doug Burgum (R): Opposes the Affordable Care Act.

He opposes the Affordable Care Act and is against the federal government’s involvement in healthcare under the rationale that commodities get more expensive as they get less competitive.

Chris Christie (R): Opposes the Affordable Care Act.

He is against the Affordable Care Act and has advocated for its repeal. He is also strongly against a single-payer system.

Ron DeSantis (R): Opposes the Affordable Care Act.

He opposes the Affordable Care Act and voted to repeal it as a Representative. While in Congress, he was a member of the House Freedom Caucus which maintained that Trump's efforts to repeal the ACA did not go far enough.

Vivek Ramaswamy (R): Opposes the Affordable Care Act.

He wishes to repeal and replace the Affordable Care Act.



Marianne Williamson (D): Supports Medicare for All.

She supports a single-payer Medicare for All universal healthcare system to “end the ACA’s waste.” As part of this new healthcare system, she hopes to promote nutrition education, fund recreation spaces, provide refundable tax credits for gym memberships.


Doug Burgum (R): Not enough information.

Chris Christie (R): Opposes the expansion of Medicare.

He expanded Medicare during his term as governor of NJ, but opposes its expansion nationally. He believes cuts to Medicare are a necessary “political risk” to maintain the US economy.

Ron DeSantis (R): Opposes the expansion of Medicare.

As governor, he overhauled Florida's Medicare care system and opposed the expansion of Medicare. He is fully against Medicare-for-all and has vowed to keep private insurance a viable option. In Florida, he expanded direct primary care involving contractual relationships between doctors and patients, partially cutting out the role of insurers.

Vivek Ramaswamy (R): Opposes Medicare cuts for seniors.

Wants to fund Medicare and Social Security by cutting 75% of the federal workforce.

Prescription Drugs


Marianne Williamson (D): 

She supports the government’s ability to negotiate prices of prescription drugs with pharmaceutical companies in order to lower costs.

Doug Burgum (R): 

As Governor of North Dakota, Burgum signed a bill enacting drug price transparency measures, requiring manufacturers to disclose certain information upon a drug price increase and notify when  a new drug exceeds price thresholds.

Chris Christie (R):

He had made fighting against the opioid epidemic a focal point during his time as governor. In addition, he expanded New Jersey’s medical marijuana program to cover veterans who suffer from PTSD and children with Tourette Syndrome. He also signed legislation allowing pharmacists to sell overdose medication without prescription. He has called for a “balance” of regulation on prescription drugs.

Ron DeSantis (R): 

As governor, he signed legislation requiring pharmaceutical companies to disclose price increases of 15% within a calendar year or 30% within a three-year period.

Vivek Ramaswamy (R):

He hopes to overhaul the FDA, stating that “FDA regulations are hypocritical, harmful, and unconstitutional.” He argues that introducing more generic drug will increase competition to lower prices and is therefore against the FDA’s regulations on generic drugs.

Gender-Affirming Care

Doug Burgum (R): Against gender-affirming care for minors.

He signed into law a bill that criminalizes gender-affirming care to minors in the state of North Dakota.

Chris Christie (R): Against government bans of gender-affirming care for minors.

He is against banning gender-affirming health care for transgender youth: “I don’t think that the government should ever be stepping into the place of the parents in helping to move their children through a process.”

Ron DeSantis (R): Against gender-affirming care for minors.

He signed a bill prohibiting gender-affirming care for minors while also inducing obstacles for adults to receive treatment.

Vivek Ramaswamy (R): Against gender-affirming care for minors.

He believes gender dysphoria is perpetuated through media and is against gender-affirming care for minors.

Marianne Williamson (D): Supports gender-affirming care for minors.

She has proposed an Equality Act to fight discrimination of transgender individuals in healthcare

This blog was written by Harry Ding, content intern (Center bias). It was reviewed and edited by Henry A. Brechter (Center bias), Malayna Bizier (Right bias), Johnathon Held (Lean Right bias), and Joseph Ratliff (Lean Left bias).