Rising Healthcare Costs Emerge as Key Issue in U.S. Elections, Fueling Democratic Campaigns

Healthcare Costs a Dominant Voter Concern

Rising healthcare costs have become a paramount concern for voters across the United States, significantly shaping the political landscape as elections approach. Recent data indicates that more than 4 in 10 voters consider healthcare costs to have a 'major impact' on their decision to vote and their choice of party. This issue consistently ranks as a leading economic worry for the public, often surpassing concerns about groceries, housing, and utilities.

The financial burden is substantial, with total U.S. healthcare spending reaching nearly $5.3 trillion in 2024, marking a 7.2% increase from the previous year. Out-of-pocket spending alone climbed to $556.6 billion in 2024, while prescription drug expenditures rose to $467.0 billion. The strain on households is evident, as approximately two-thirds of adults express being 'very worried' or 'somewhat worried' about their ability to afford healthcare for themselves and their families. This concern translates into tangible consequences, with one-third (36%) of adults reporting that they have skipped or delayed necessary healthcare in the past 12 months due to cost.

Democratic Campaigns Prioritize Affordability

In response to widespread voter anxiety, Democratic political campaigns nationwide are placing healthcare affordability at the forefront of their platforms. Strategists and candidates are actively highlighting the issue, often sharing personal stories of individuals facing escalating medical bills and insurance premiums. For instance, some voters have experienced significant increases, such as a $200 jump in Affordable Care Act (ACA) premiums or a $520-a-month ACA policy after enhanced subsidies expired.

Democrats are framing healthcare as a 'life-or-death question' and are conducting campaign activities outside hospitals and pharmacies to underscore their commitment to addressing these costs. The advocacy group Protect Our Care's executive director, Brad Woodhouse, noted that healthcare is 'a banger of an issue for Democrats' and predicted it 'will be part of every single campaign, up and down the ballot.'

Policy Proposals from the Democratic Platform

The 2024 Democratic platform outlines a comprehensive set of proposals aimed at expanding access and reducing healthcare expenses. Key commitments include:

• Permanently extending enhanced ACA premium subsidies.
• Creating new dental, vision, and hearing benefits under Medicare.
• Banning surprise billing for ground ambulance services.
• Adding 'at least' 50 drugs annually to the Medicare drug price negotiation program.
• Implementing a $2 limit on Medicare cost-sharing for some generic drugs.
• Increasing transparency within the pharmacy benefit manager industry.
• Expanding the Medicaid program, including extending postpartum coverage to a full year.
• Utilizing antitrust laws to prevent mergers among hospitals, insurance companies, and pharmaceutical firms that could increase prices.
• Excluding all medical debt from credit reporting.
• Strengthening the nation's mental and behavioral healthcare system.

Vice President Kamala Harris's campaign has also emphasized plans to expand and strengthen the ACA, make permanent the Biden-Harris tax credit enhancements that have lowered premiums by an average of approximately $800 a year, and extend the $35 cap on insulin and $2,000 cap on out-of-pocket spending for seniors to all Americans.

Republican Stance and Impact on Costs

Conversely, Republican actions have drawn criticism from Democrats regarding healthcare costs. Republicans have reportedly cut around $1 trillion from Medicaid over a decade and opted not to extend COVID-era subsidies that had reduced the cost of Affordable Care Act health plans. These decisions have led to concerns that millions of Americans could face significant increases in insurance premiums, with some estimates suggesting an average rise of 114% for those relying on Obamacare tax credits if subsidies are not extended. While Republicans defend their votes as efforts to control ballooning health spending, the issue remains a significant point of contention in the electoral debate.