Ohio Sen. JD Vance and Minnesota Gov. Tim Walz took the stage Oct. 1 for the only vice presidential debate at the CBS Broadcast Center in New York City.
During the 90-minute broadcast, moderated by CBS News' Nora O'Donnell and Margaret Brennan, the candidates discussed climate change, the economy, immigration and geopolitical tensions. Several questions about healthcare topics were asked.
Four takeaways for healthcare leaders, with context:
1. Reproductive rights: Mr. Vance underscored running mate Donald Trump's position that abortion policy be left to states to decide, while Mr. Walz reinforced Ms. Harris' vow to restore the federal right to abortion, if elected.
Ms. O'Donnell introduced the topic by asking Mr. Walz about a bill he signed into law in 2023 that made Minnesota one of the least restrictive states in the nation on abortion. She asked whether Mr. Walz supports late-term abortions — a follow up to a claim made by Mr. Trump during the presidential debate in September.
"That's not what the bill says," Mr. Walz said. Mr. Vance also took aim at the Minnesota law, saying that the statute suggests physicians who perform abortions in cases where the child survives are under "no obligation to provide lifesaving care" after a "botched" late-term abortion.
According to a fact check from CBS News, the bill Mr. Walz signed in 2023 was an update to state law surrounding care for infants "born alive" after an abortion. The previous and updated law both stated an infant "born alive shall be fully recognized as a human person, and accorded immediate protection under the law."
The updated law states medical professionals are required to take all reasonable measures "to care for the infant who is born alive," which differs from what the previous version of the law stated: take all reasonable measures to "preserve the life and health of the born alive infant." The change has been criticized by advocates who say it allows parents of infants not expected to survive to dismiss certain interventions.
Ninety-three percent of abortions occur during the first trimester, while 1% take place after 21 weeks, according to the Pew Research Center.
Mr. Walz claimed that Project 2025 — a conservative policy agenda that Mr. Trump has tried to distance himself from — would require a national registry of pregnancies. In response to those claims, Mr. Vance said "certainly we won't" support such a measure. Project 2025 doesn't specifically call for a federal registry of pregnancies, though it does tout state reporting on how many abortions occur within the state, including details on when and why the abortion occurred, according to a CBS News fact check.
When asked about a national abortion ban, Mr. Vance said he "never supported" one, but did call for setting minimum national standards. Previously, he supported a federal ban after 15 weeks. During the vice presidential debate, Mr. Trump posted a message on social media platform X stating he would not, "under any circumstances," support a federal abortion ban and that he would veto such a ban if it came across his desk as president. During the September debate, the former president did not explicitly state whether he would veto a national ban.
Mr. Walz challenged the Trump campaign's position that the legality of abortion be left to the states by sharing a story of a woman who died while traveling from Georgia, which prohibits abortion at 20 weeks, to North Carolina, which has a less restrictive policy, to seek care. Ms. Harris similarly used her comments about reproductive rights during the presidential debate to appeal to healthcare providers who have had to navigate a patchwork of state bans with varying and often vague language on exceptions.
Read more about the abortion landscape in the U.S. and the federal Emergency Medical Treatment and Labor Act here and here.
2. The ACA: Mr. Vance and Mr. Walz offered differing views on healthcare policy, particularly regarding the ACA and coverage protections for Americans with preexisting conditions.
Though details on Mr. Trump's healthcare plan have been sparse, Mr. Vance has previously suggested that the former president would reintroduce risk pools in the individual market if elected, a practice that existed before the ACA. During the debate, Ms. O'Donnell asked Mr. Vance how he would ensure that Americans with preexisting conditions wouldn't pay more.
"We currently have laws and regulations in place, in place right now that protect people with preexisting conditions," he said. "We want to keep those regulations in place, but we also want to make the health insurance marketplace function a little bit better."
The "laws and regulations in place" that protect individuals with preexisting conditions fall under the ACA, according to a fact check from NPR.
He argued that improving the marketplace through various reforms, including promoting price transparency and allowing states to experiment with how to cover the chronically and non-chronically ill, will lower costs and increase care access.
Mr. Walz pushed back on the idea of returning to pre-ACA practices, arguing it would allow insurers to exclude individuals with preexisting conditions.
"I think the idea of making sure the risk pool is broad enough to cover everyone, that's the only way insurance works," he said. "When it doesn't, it collapses."
Mr. Walz argued that Mr. Trump's repeated attempts to repeal the ACA undermined protection for vulnerable groups. He asserted that the ACA is functioning well and stressed the need for a broad risk pool to ensure effective insurance coverage, particularly for older Americans and those with chronic illnesses.
Marketplace enrollment reached a record high of more than 20 million in 2024, partly due to premium subsidies set to expire at the end of 2025. Democrats have introduced the Health Care Affordability Act, which aims to permanently extend the subsidies. The move would add $335 billion to the national deficit between 2025 and 2034, according to the Congressional Budget Office.
3. Prescription drugs: The candidates also addressed prescription drug costs and access when discussing the economy and the ACA.
Mr. Walz pointed to recent legislation passed under the Biden-Harris administration to address high drug prices, including a $35 cap on insulin prices. He also commended the Biden-Harris administration's move to give Medicare the authority to negotiate the price of drugs without generic or biosimilar competition under Medicare Parts B and D.
Mr. Vance also touted Mr. Trump's efforts to lower drug prices when in office. He said prescription drug prices increased by just 1.5% when Mr. Trump was in office, compared to 7% during the Biden-Harris administration. He also called for more drugs to be manufactured domestically.
USA Today offered a more granular view of drug pricing trends in a fact check: Drug costs fluctuated during Mr. Trump's term, and increased under the Biden administration, according to a chart from the Bureau of Labor Statistics' Consumer Price Index. From January 2017 to January 2018, costs increased 2.4% before dropping by 0.5% as of January 2019, marking the first year-over-year decrease during the month of January in decades. By January 2020, costs grew again by 2.5% and then dropped 2.4% the following January.
4. Mental healthcare and gun violence: Mental health emerged as another topic of conversation when the candidates were asked about America's gun violence epidemic. Mr. Vance emphasized the need to address the root causes of the mental health crisis, alongside efforts to boost law enforcement efforts and school security.
Mr. Walz cautioned against stigmatizing mental health, saying "just because you have a mental health issue doesn't mean you're violent." He said lawmakers must find balanced solutions to respect the Second Amendment while also addressing the role of firearms in violence.
In recent years, health systems nationwide have begun to recognize and address gun violence as a nonpolitical health issue. This June, U.S. Surgeon General Vivek Murthy, MD, also declared gun violence an urgent public health crisis, calling for a multi-pronged approach to address it. At the same time, health systems are also grappling with rising demands for mental healthcare. Patients experiencing mental healthcare crises are increasingly seeking care in emergency departments due to a lack of access to appropriate care settings. The percentage of ED visits with a mental health diagnosis rose from 6.6% in 2007-08 to 10.9% in 2015-16, according to the CDC.