Health care is one of the most complex topics in American politics, especially in the midst of a pandemic. Under the umbrella of health care (open in new tab), women's rights (open in new tab) are at risk, endemic racism (open in new tab) and sexism (open in new tab) are amplified, and ordinary Americans may be forced into hundreds of thousands of dollars' worth of debt.

To oversimplify how politics and health care intersect, Democrats tend to favor increasing rather than decreasing health care coverage and increasing government action to control costs and establish market equity, while Republicans support privatizing health care and reducing government oversight in principle Republicans tend to support privatizing health care and reducing government oversight in principle. However, in the current climate of unprecedented political divisiveness, in addition to the pandemic, the party lines are not so clear-cut.

Many Democrats insist that the issues in 2020 are about human rights, not deductibles and co-pays. The Trump administration has issued health care-related policies and mandates that marginalize groups including women, LGBTQ+ people, and people of color. Here is what is at stake and where both presidential candidates stand on some of today's most pressing health care topics.

Trump and Pence The current administration, which has overseen the current pandemic response, has leaned toward ignoring scientific sources and advice (opens in new tab) and existing pandemic infrastructure (opens in new tab). It has expressed contradictory views on the wearing of masks (opens new tab) and promoted unproven and potentially deadly treatments (opens new tab). Trump has also threatened to withdraw from the World Health Organization (opens new tab).

Harris and Biden: Harris and Biden have a section of their website (opens in new tab) devoted to their coronavirus plan, which includes increasing reliable testing and personal protective equipment (PPE) and reconfiguring safety equipment to mitigate the effects of COVID-19. Harris proposed the COVID-19 Racial and Ethnic Disparities Task Force Act. This would ensure that solutions are equitable for populations that are seeing higher health care disparities and mortality rates.

Trump and Pence The current administration has fought the Affordable Care Act, enacted under the Obama and Biden administrations, by repealing the individual mandate (open in new tab) requiring citizens to purchase health insurance. They have proposed reauthorizing the ability of insurance companies to discriminate based on medical history (opens in new tab).

Harris and Pence Biden, of course, participated in the creation of the ACA during the Obama administration and support its strengthening and improving Medicare's effectiveness. His plan could still leave gaps in coverage, and Harris and Biden initially clashed on this point. Now they are running mates, and the newly announced health care plan (open in new tab) is a hybrid of sorts, with a "Medicare-like" public option for consumers and also a more affordable private insurance option.

Trump and Pence: since the current administration took office, improvements in racial disparities in health care have stalled (open in new tab). The president's claims of producing results that reduce inequality for black Americans have been denied or publicized as hyperbole (opens in new tab).

Biden and Harris: Harris and Biden address health care for communities of color (opens in new tab) on their website. They say their plan includes health care tax credits for the poor and expanding insurance coverage, especially for low-income Americans. They also want to increase support for community health centers, especially for underserved populations.

Trump and Pence The Trump Administration attempted to repeal the ACA (opens in new tab) and remove basic care provisions for women (did not pass the Senate) in the American Health Care Act of 2017. The administration also threatened to repeal Roe v. Wade (opens in new tab), forced Planned Parenthood out of Title X funding (opens in new tab), and was recently challenged by the Supreme Court (opens in new tab) on the grounds that employers' religious or moral objections to employee the go-ahead to allow employers to deny contraceptive care to their employees on the basis of religious or moral objections.

Biden and Harris: Biden has an "agenda for women" (open in new tab) in which he states, among other things, that he plans to "promote women's economic and physical security and enable women to fully exercise their civil rights." His views on women's rights are changing (open in new tab). Harris disputed his views (open in new tab) in the debate, but both believe in stopping Medicaid from providing abortion services and repealing the Hyde Act, which disproportionately affects low-income people and women of color.

Trump and Pence The United States is one of the few industrialized nations without a "publicly accountable process (open in new tab)" for drug prices. Costs are rising as technology improves, but there is no system to determine cost to value. The current administration is flip-flopping on this issue. The House "Pelosi Bill" attempts to address pharmaceutical costs broadly and has passed the House but has not been endorsed by the Senate (opens in new tab). The Senate Finance Committee bill was reintroduced in July (opens in new tab), although it does not do much in terms of comprehensive changes.

Harris and Biden: Biden was initially in favor of using other countries' costs as the basis for U.S. drug prices, which set limits on costs (opens in new tab). The Biden-Harris website (opens in new tab) lists drug importation as part of their health care plan, as well as limits on price increases, forcing drug companies to negotiate with Medicare and limiting tax benefits, and improving the supply of generic prescription drugs.

In addition to these topics, mental health treatment, access to telemedicine, addiction treatment, transgender rights (opens in new tab), and long-term care as the baby boom generation ages in the US continue to be important topics in the election and beyond.