Good morning. Today, my colleague Margot Sanger-Katz writes about the presidential candidates' health policy proposals. We're also covering the Middle East, the South China Sea and the N.F.L.'s Uncrustables obsession. —David Leonhardt
On health care
After several elections with health care at the forefront, the issue has faded into the background this cycle. But the stakes are still high. The next president could influence how many people have health insurance, how much many pay for it, the prices of prescription drugs and more through regulatory power alone. In the event that either candidate is elected with legislative majorities, the differences could be even larger. The Morning has been writing on how the election will matter for major areas of public policy. Today, I'll break down the stakes for health care. InsuranceFor people who use Obamacare, a lot of money is at stake. During the pandemic, Democrats raised the subsidies that help 20 million Americans buy their own insurance. Poor Americans can get covered without paying a cent, and even people making north of $100,000 got help with premiums. But if Congress does nothing, the new subsidies will expire at the end of next year. That would likely leave more than three million uninsured — and would make nearly everyone insured through Obamacare pay more. Donald Trump's campaign says he opposes an extension, which might cost hundreds of billions of dollars. Kamala Harris wants the subsidies to be permanent, though she probably wouldn't get her way if Republicans control Congress.
The candidates are also likely to approach key regulations of Obamacare differently. In his first term, Trump encouraged the sale of lightly regulated insurance plans that cost less — and covered fewer medical problems. He also pulled back on advertising for people to enroll in Obamacare. The Biden administration reversed most of these changes, and Harris would likely keep such moves in place. Trump could also weaken the requirement for insurers to cover all forms of contraception. In his first term, he let employers claim exemption on religious or moral grounds. Drug pricesA rare point of agreement between the two candidates is that the United States should pay less for prescription drugs. This is an area where the president could have a lot of influence, even if Congress doesn't cooperate. The Biden administration signed legislation allowing Medicare to negotiate the price of certain drugs with the companies that make them. Ozempic and Wegovy, the blockbuster diabetes and weight loss drugs, could be negotiated next year. How aggressively will officials haggle over their price? It depends who's running Medicare.
Harris is a fan of the new law and wants it to apply to more drugs. Trump has been quiet about the specific provision, but he has lamented for years that Americans pay more for drugs than the rest of the world. When he was president, he wasn't able to get any major legislation passed, but he tried various rules — blessing Canadian drug imports, forcing drug companies to mention most prices on television ads — to achieve similar goals. But Trump's policies here are difficult to predict. On this topic, he is out of step with congressional Republicans and conservative health care scholars, who mostly oppose the drug negotiation law. How far he goes may depend on whom he appoints to the big government jobs. Medicare and MedicaidOn Medicare, the federal insurance program for Americans over 65, both Trump and Harris have vowed not to cut benefits. But when it comes to Medicaid, which covers poor and disabled Americans, there are major differences between the candidates. Trump allowed state Medicaid programs to impose work requirements, limiting coverage to people who could prove they worked a certain number of hours a week. He could let Republican-led states try other experiments. With a congressional majorityIf allies of either candidate control both houses of Congress, the differences could be huge. Lawmakers could authorize Harris to negotiate for more drugs. She has also proposed to expand Medicare so it covers seniors' hearing, vision and home-based care. Those changes would be costly but could be accomplished with a bare-majority vote in the Senate. Her other proposals — such as limiting insulin co-payments to $35 for all Americans or capping everyone's out-of-pocket drug spending to $2,000 a year — would probably require either 60 Senate votes or the end of the filibuster. If Republicans control Congress and the White House, they might cut Medicaid. Trump has not campaigned on reductions. But he has not pledged to protect the program, and he proposed major cuts in every one of his presidential budgets. None passed. Trump has suggested he might be open to another Obamacare repeal attempt. But Republicans in Congress don't seem interested. Bottom line: Kamala Harris has offered policies that would lower out-of-pocket costs for many Americans and preserve or expand health insurance coverage. Donald Trump has been vaguer, and his agenda is a little harder to predict. But his allies have embraced policies that would probably increase insurance premiums for people who buy their own insurance — and raise the number of Americans who are uninsured. Both candidates would probably take steps to lower the price of prescription drugs. Related: An opaque industry — pharmacy benefit managers — secretly inflates the price of prescription drugs.
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Other Big Stories
Opinions Members of The Editorial Board share what is motivating their vote this year. Pharmacists have become more skeptical of people looking for opioids. But when they refuse to fill prescriptions, patients turn to the black market, Elizabeth Chiarello writes. Gail Collins and Bret Stephens discuss the election. Here are columns by David French on anti-Trump conservatives and Nicholas Kristof on Trump's age. The Times Sale starts now: Our best rate for readers of The Morning. Save now with our best offer on unlimited news and analysis as part of the complete Times experience: $1/week for your first year.
Pluckley: Visit England's most haunted village. "Ketamine queen": Read about the woman at the center of the investigation into Matthew Perry's death. Endangered: Can whale moms save their species? Meet one of them. Metropolitan Diary: Deli meat math. Lives Lived: Antonio Franklin, known as DJ Clark Kent, was a respected hip-hop insider who had influential relationships with many leading rappers. He died at 58.
N.F.L.: The Washington Commanders defeated the Chicago Bears with Jayden Daniels's game-winning Hail Mary pass. N.B.A.: Golden State Warriors star Steph Curry sprained his ankle. His team lost, 112-104, to the Los Angeles Clippers. M.L.B.: Shohei Ohtani will play for the Los Angeles Dodgers in Game 3 of the World Series tonight after injuring his shoulder in Game 2.
Uncrustables, peanut butter and jelly sandwiches found in supermarket freezers, are popular in the N.F.L. Brock Purdy ate one at his locker before the Super Bowl. Andy Reid once offered them to his players as a reward. At the end of 2023, The Athletic tried to find out just how many of these snacks the league went through that year. The answer: Some 80,000. See a breakdown by team. More on culture
Poach fish fillets in scallion oil. Clean your towels. Here's how. Keep warm with a space heater. Take our news quiz.
Here is today's Spelling Bee. Yesterday's pangram was flagpole. And here are today's Mini Crossword, Wordle, Sudoku, Connections and Strands. Thanks for spending part of your morning with The Times. See you tomorrow. Sign up here to get this newsletter in your inbox. Reach our team at themorning@nytimes.com.
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Monday, October 28, 2024
The Morning: The stakes on health care
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