Immigration and the economy emerged as major topics during the 90-minute presidential debate Sept. 10 between former President Donald Trump and Vice President Kamala Harris. However, the candidates spent some of the time on two healthcare topics: abortion and the Affordable Care Act.
Here are three key healthcare takeaways from the debate at Philadelphia's National Constitutional Center, moderated by ABC News anchors David Muir and Linsey Davis, with context:
Economy: Mr. Muir began the debate by asking the candidates about the economy, a top concern for 81% of registered voters, according to Pew Research Center polling, who consider it crucial for their Nov. 5 vote. Mr. Muir asked the candidates whether they believe Americans are better off today than they were four years ago.
The two spoke broadly about their plans to combat inflation and lower the cost of living. As of August, the 12-month inflation rate, as measured by the Consumer Price Index, stands at 2.5%, the smallest 12-month increase since February 2021, according to the latest data from the Bureau of Labor Statistics.
Ms. Harris said she plans to build an "opportunity economy" that would include a $6,000 child tax credit for young families and a $50,000 tax deduction for start-up small businesses. Mr. Trump said his plan centers on tariffs of up to 20% for countries on foreign imports.
Healthcare did not come up directly in the candidates' remarks about the economy, though polling has found the cost of healthcare is a burden for many Americans. Twenty-one percent of adults say they have avoided filling a prescription due to cost, and 61% said they have gone without needed care because of the cost, according to a KFF poll published in March.
Abortion: The topic came up about 20 minutes into the debate, when Ms. Davis asked Mr. Trump why women should trust him on the issue after inconsistent messaging on the six-week abortion ban in Florida, his home state. In August, the former president told NBC News he believed the state's six-week ban was "too short" and that he would vote "that we need more than six weeks," signaling he would vote in favor of a ballot measure that would expand access to abortion. A day later, he told Fox News he will be voting "no" on the amendment.
In his response to Ms. Davis's question, Mr. Trump stated that Democrats support abortions in the ninth month and "after birth," which he called "execution." The comments drew a fact check from Ms. Davis, who said there is no state in the country where it is legal to kill a baby after birth. Ninety-three percent of abortions occur during the first trimester, while 1% take place after 21 weeks, according to the Pew Research Center.
Mr. Trump suggested Ms. Harris would back abortion up to the ninth month and challenged her to clarify her stance on third-trimester abortions. Ms. Harris did not directly respond to the question, instead asking why Mr. Trump wouldn’t answer a question on whether he would veto a national abortion ban.
As he did in the June debate with President Joe Biden, Mr. Trump also underscored his position that the legality of abortion should be left to states to decide, touting his role in the Supreme Court overturning Roe v. Wade in 2022. He reiterated support for exceptions to bans in cases of "rape, incest and life of the mother."
Meanwhile, Ms. Harris said if elected, she would support a restoration of the federal right to abortion. The vice president also used her response to appeal to healthcare providers, who have had to navigate a patchwork of state bans with varying and often vague language on exceptions. Since the overturning of Roe v. Wade, 14 states have enacted a total abortion ban and seven states have gestational limits of 18 weeks or fewer, according to a tracker by the Guttmacher Institute.
The Biden administration has focused on the Emergency Medical Treatment and Labor Act — a decades-old federal law requiring hospitals to provide all patients appropriate emergency care, including a medical screening examination and stabilizing treatment, if necessary — in an effort to provide clarity and guidance to healthcare providers who have expressed feeling stuck between the repercussions they face if they violate their state laws and complying with federal law. Read more on EMTALA and the abortion landscape in the U.S. here.
Ms. Harris stated that Mr. Trump would sign a national abortion ban if re-elected, which he denied. According to a CBS News fact check, Mr. Trump has not explicitly endorsed such a ban. He shared the idea of a 15- or 16-week ban in March, though has been more firm in his stance that abortion legality belongs with the states.
Both candidates briefly expressed support for in vitro fertilization treatments. Late in August, Mr. Trump pitched an IVF coverage mandate for payers in a bid to expand access to the treatments, which can cost up to $20,000 for a single cycle.
The Affordable Care Act: The ACA surfaced as a topic near the end of the debate. Ms. Davis asked Mr. Trump if he still intended to replace the healthcare law ― and if so, what the plan is. When pressed by Ms. Davis, Mr. Trump said he has "concepts of a plan" and that he "would only change it if we come up with something better and less expensive." "And there are concepts and options we have to do that," Mr. Trump added. "And you'll be hearing about it in the not-too-distant future."
The Republican Party has shifted away from its longstanding campaign to repeal the ACA, passed under President Barack Obama in 2010. However, the healthcare law re-emerged in the election cycle when Mr. Trump in November used Truth Social to identify healthcare as a key issue in his 2024 campaign, promising to replace the ACA if re-elected.
According to a tracking poll conducted by KFF, 43% of adults supported the healthcare law in November 2016 around the time of Mr. Trump's election. The latest survey by KFF, conducted in April, showed 62% of Americans held a favorable opinion of the ACA, while 37% viewed it unfavorably.
In 2021, the Biden administration enacted the American Rescue Plan Act, which temporarily enhanced subsidies for individuals purchasing health coverage through ACA marketplaces. These increased subsidies are set to expire at the end of 2025.
Meanwhile, the Biden administration released new data Sept. 10 showing that 1 in 7 U.S. residents have been covered through the ACA marketplaces since January 2014. During the debate, Ms. Harris emphasized her committment to maintaining and growing the ACA, highlighting that the law prevents insurance companies from denying coverage to those with pre-existing conditions.
"I don't have to tell the people watching tonight, you remember what that was like? Remember when an insurance company could deny if a child had asthma, if someone was a breast cancer survivor, if a grandparent had diabetes?" Ms. Harris said.
Ms. Harris also touted insulin prices and drug price negotiations briefly as part of larger comments on the ACA. Mr. Biden also touted the prices during his debate with Mr. Trump in June.
CBS News broke down the issue in a fact check after the June debate: In 2020, during Mr. Trump's presidency, Medicare created a voluntary program in which some health plans and insulin manufacturers agreed to cap out-of-pocket costs at $35 per month. By the end of 2021, about half of Medicare Advantage or standalone prescription medication plans were participating. When Mr. Biden signed the Inflation Reduction Act into law, insulin costs were capped at $35 per month for Medicare beneficiaries, ending the voluntary program.
Coverage from the previous Biden-Trump debate can be found here.