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Donald Trump Record

• Issued an that stated his administration’s official position supporting repeal of the ACA; it also provided federal agencies with flexibility to grant waivers, exemptions and delays of ACA requirements.
• for cost-sharing subsidies, which contributed to increased premiums.
• non-ACA compliant plans, including short-term limited duration insurance, which could exclude coverage for pre-existing conditions.
• changes to the ACA that would weaken pre-existing protections and reduce funding substantially through a block grant to states.
• that included work requirements as a condition of Medicaid eligibility, premiums, and other eligibility restrictions.

Kamala Harris Record

Biden-Harris Administration

• Supported and .
• Pursuing permanent expansion of insurance subsidies.
• Trump administration expansion of short-term limited duration insurance.
• that provide states with a financial incentive to adopt Medicaid expansion.
• demonstration waivers, approved by the Trump Administration relating to Medicaid work requirements.

As a Senator:

• Supportive of and morbidity, including encouraging states to adopt the postpartum Medicaid coverage extension.

Donald Trump Record

• a Conscience and Religious Freedom Division at HHS and issued an executive order directing federal agencies to expand religious protections, actions that created opportunities for gender and sexuality-based discrimination in certain circumstances.
• from serving in the U.S. military, limiting their ability to access necessary medical care and services.

Kamala Harris Record

Biden-Harris Administration

• Trump administration regulatory expansions of conscience regulations that had created potential opportunities for gender and sexuality-based discrimination (which multiple federal courts had found to be unlawful).
• through an executive order (EO) to expand support and resources for trans veterans and increase access to gender-affirming medical care for service members.
• an EO to extend existing federal nondiscrimination protections to LGBTQ+ Americans. The EO aims to address the barriers and discriminatory policies LGBTQ+ patients face when seeking comprehensive health care, including mental health care and reproductive health care. It also expands access to gender-affirming care.

As a Senator:

• Co-sponsored the Equality Act to provide civil rights protections for the LGBTQ+ community. The bill would codify protections for LGBTQ+ patients to obtain health care services without discrimination.

Donald Trump Record

• Finalized regulations to the that:
  • Block federal funding to family planning facilities that also provide abortion services (with other funds).
  • Prohibit participating sites from referring pregnant clients to clinicians that provide abortions.
  • Block clinicians from providing counseling that includes information on abortion.
  • These regulations disqualified approximately 1000 sites from participating in the program.
• Reinstated and expanded the “” which prohibits foreign NGOs from performing or promoting abortion for family planning as a condition of receiving U.S. global health assistance.
• broadening employer’s religious and moral exemptions from providing coverage for contraceptives under the ACA.
• Appointed three justices to the Supreme Court, all of whom sided with the majority opinion in Dobbs v. Jackson Women’s Health Organization.

Kamala Harris Record

Biden-Harris Administration

• Following the Dobbs decision, issued an Executive Order and affirming that abortions performed to stabilize the health of people experiencing pregnancy-related emergencies are protected by the federal Emergency Medical Treatment and Active Labor Act, even in states that ban abortions.
• Released a nationwide , which includes proposals to expand Medicaid postpartum coverage from 2 to 12 months, create a “Birthing-Friendly” hospital designation, and launched a national support hotline for pregnant individuals..
• Issued a rule protecting privacy by to prohibit the disclosure of protected health information related to lawful reproductive health care in certain circumstances.
• the first over-the-counter oral contraceptive.
• Revoked Trump Administration changes to Title X and the Mexico City Policy, restoring funding and access to reproductive care

As a Senator:

• Co-sponsor of the , which prohibits state or local governments from imposing certain restrictions on access to abortion services.
• Sponsored a bill that would require private health insurance plans to cover the full cost of treatments and any related screenings.

Donald Trump Record

• a blueprint to lower drug prices. The blueprint identified four key strategies for reform including: improved competition, better negotiation, incentives for lower list prices, and lower out-of-pocket costs.
• legislation into law allowing pharmacists to disclose to patients when the cash price of a drug is lower than the cost using their insurance. The proposal was included in the Trump Administration’s blueprint for lowering drug prices.
• Established the Innovation Center’s , a voluntary model that allows participating Medicare Part D plans to limit monthly insulin costs to $35.
• the Importation of Prescription Drug final rule, which established a pathway to allow states to import prescription drugs from Canada. 
• final rule to eliminate drug rebates in Medicare Part D. This approach would increase Part D premiums and Medicare spending. (The rule has been delayed by the until 2032).

Kamala Harris Record

Biden-Harris Administration

• Vice President Harris was the tie-breaking vote in the Senate to pass the . The law implemented a longstanding ACP priority, allowing Medicare to negotiate lower prescription drug prices for a set number of drugs. Additionally, the law requires drug companies to pay rebates to Medicare if they raise prices faster than inflation and limits the cost of insulin at $35 per product per month for seniors.
• initial guidance on the requirements and parameters of the new Medicare Drug Price Negotiation Program for 2026.
• the first ten prescription drugs selected for Medicare price negotiation with manufacturers.
• Issued a that would, if finalized as proposed, address anticompetitive and anti-consumer practices in Medicare Advantage (MA) plans. Further, it would implement updates to MA payment that improve payment accuracy, address gaming, and recover overpayments.
• Directed the Federal Trade Commission (FTC) to the impact of pharmacy benefit managers (PBMs) and consolidation on the health care industry.

Donald Trump Record

• on Maintaining American Leadership in Artificial Intelligence
  • Calls for the United States to stay up to date with developments in AI, foster trust in the public, invest in R&D, reduce barriers,
  • Established the
• The National Science Foundation (NSF), and the Department of Energy (DOE) announced more than $1 billion in awards for AI and QIS R&D Institutes.
• In 2020, issued an executive order on in the Federal Government.

Kamala Harris Record

Biden-Harris Administration

• In November 2023, at the , Harris announced the launch of the US AI Safety Institute.
• , she spoke again on AI, announcing new OMB for the use of AI in government including new standards, a call for transparency and internal oversight.
• White House Office of Science and Technology Policy issued the
  • Set of principles and practices to help the design use and development of AI to protect the rights of people.
  • Administration issued an on the Safe, Secure and Trustworthy Development and Use of Artificial Intelligence.
• Issued through HHS and OCR strengthening HIPAA privacy rules for reproductive health, prohibiting the use or disclosure of protected health information (PHI) reproductive health care.

Donald Trump Record

• Issued a regulation , which allow legal semi-automatic weapons to fire more rapidly. This regulation was later struck down by the Supreme Court.
• requiring those eligible for Social Security Administration mental disability payments to be blocked from buying guns.
• Department of Justice adopted a ,” allowing more individuals with outstanding arrest warrants to be eligible to purchase firearms.

Kamala Harris Record

Biden-Harris Administration

• Actively supported and signed the into law, enhancing background checks, closing purchasing loopholes, funding violence intervention programs, and improving access to mental health services.
• Vice President Harris oversees the first-ever , established by the administration to coordinate and bolster federal efforts on reducing firearm violence.
• Dozens of executive orders have been issued on a wide range of issues, including curbing access to “,” promoting safe storage, and .
• Launched the first-ever to facilitate state implementation of red flag laws.
• The Office of the Surgeon General declaring firearm violence to be a public health crisis.

As a Senator:

• Cosponsored the , which sought to prohibit individuals with a history of hate crimes from purchasing and possessing firearms.
• Cosponsored many additional bills, including the Gun Violence Prevention Research Act of 2019, calling for expanded background checks, bans on assault weapons, safe storage, and regulations on firearm dealers.

Donald Trump Record

• Formally , an agreement in which 196 countries committed reduce emissions to limit global temperature rise to below 2 degrees Celsius above preindustrial levels.
• Rolled back :
  • Reduced regulations on toxic emissions such as mercury from power plants.
  • Weakened rules limiting venting or flaring of methane from oil and gas production on public lands.
  • Weakened reporting requirements for methane emissions.
• Finalized a rule protected by the Clean Water Act, leaving many bodies of water to state jurisdiction and constraining pollution prevention efforts by the Environmental Protection Agency
• Required the Environmental Protection Agency to .

Kamala Harris Record

Biden-Harris Administration

• Actively supported and signed the into law, which invests over $300 billion in increasing clean energy production and reducing greenhouse gas emissions.
• Issued executive orders advancing environmental justice, increasing engagement with communities most impacted by climate change, addressing gaps in research and data, and creating a White House Office of Environmental Justice.
• Launched the initiative, providing billions of dollars in grants through different federal agencies directly to communities overburdened by pollution.

As a Senator:

• Introduced the , aiming to increase environmental equity by requiring the federal government to consider the impact of environmental regulations or laws on communities most impacted by climate change.

As the California Attorney General:

• of offshore fracking off the coast of California.
• from multiple oil and gas companies, including BP and Chevron, over allegations of pollution law violations.

As District Attorney of San Francisco:

• to address environmental crimes and prosecuted several companies for violations of hazardous waste laws.

Donald Trump Record

• In 2020, on improving rural health and telehealth access:
  • Community Health Access and Rural Transformation was developed.
  • Trump Administration invested up to $75 million for up to 15 rural communities to participate.
  • Included direction to invest in physical and communications health care infrastructure.
• with 16 federal departments to create a to connect rural leaders with resources and data with the purpose of combatting drug addiction in rural areas.
• In 2017, Administration established the Interagency Task Force on Agriculture and Rural prosperity through :
  • In 2018 this task force published report with over
  • In 2019, launched. Designed to improve broadband access for rural communities.
• in 2018 “Streamlining and Expediting Requests To Locate Broadband Facilities in Rural America”

Kamala Harris Record

Biden-Harris Administration

• In 2021, passed Congress and was signed into law, which included related to rural health:
  • $500 million in The Emergency Food Assistance Program.
  • $425 million in funding to support COVID-19 testing and mitigation in 4,200 rural health clinics.
  • Over $100 million for rural health clinics to support vaccine outreach.
  • Provided $500 million for USDA to create the Emergency Rural Health Care Grant Program.
  • Provided $8.5 billion to compensate clinicians serving rural Medicare, Medicaid and CHIP patients for lost revenue and increased expenses from the PHE.
• Provided discounts for households on their internet bills to make access more affordable.

Donald Trump Record

• During the COVID-19 public health emergency (PHE), telehealth services were rapidly expanded:
  • On March 13, 2020, President Trump announced a PHE declaration. In line with the declaration, under the 1135 waiver authority (for the duration of the PHE).
• on Improving Rural Health and Telehealth Access in 2020.
  • Calls for investment in rural payment models, communications infrastructure, expansion of telehealth flexibilities beyond the PHE, additional telehealth services offered to Medicare beneficiaries.
• In 2017, announced to expand health care access for Veterans including geographic flexibilities, telehealth and appointment request apps.

Kamala Harris Record

Biden-Harris Administration

• in campaign remarks in April 2024.
• In FY 2021, Biden Harris Administration, through HRSA, delivered more than to improve telehealth in rural and underserved communities.

As a Senator:

• Sole sponsor of the (115th Congress).