Health Implications of a Trump vs Biden Administration

If Donald Trump is re-elected, American health inequity is poised to worsen. While nearly all Americans will experience negative health effects as a result of another Trump administration, his social and health policies will harm disadvantaged populations the most. Electing Joe Biden would result in a healthier and more just America.

The United States leads the world in both COVID-19 cases (7.7 million) and deaths (216,000). COVID has disproportionate health impacts on the sick and elderly, and it’s particularly lethal for people of color. Over half of Americans don’t think that Trump is handling the pandemic well—and nearly all adults in other developed countries agree. Additionally, Trump plans to withdraw the US from the World Health Organization (WHO), which would be another major threat to public health: America will lose access to yearly influenza vaccines and a potential COVID vaccine. Biden announced in July that, if elected, he will re-enter America into the WHO.

Trump has spent his administration dismantling the Affordable Care Act (ACA), though his administration has yet to propose an alternative to it. If it’s repealed entirely, millions of Americans will lose healthcare coverage. Vulnerable populations will be harmed by rising prescription drug costs and Medicare/Medicaid premiums. People with pre-existing conditions won’t be guaranteed coverage. Preventative services like screenings, contraceptives, and vaccinations will no longer be free.

Biden has pledged to keep and improve the ACA. In line with this goal to bolster American healthcare, Biden has proposed a comprehensive health policy plan to address social determinants of health (factors like income and neighborhood environment that influence a person’s wellbeing). He plans on reducing health inequity by increasing funding for meals, transportation, home modifications, and day programs that benefit seniors and the disabled.

While Trump did instruct the Centers for Medicare and Medicaid Services (CMS) to allow more flexibility for the chronically ill during the pandemic, he has spent most of his presidency building barriers to healthcare access for disadvantaged populations.

Under Trump’s guidance, the CMS has encouraged states to revoke Medicaid recipients’ healthcare if they do not work, allowed states to get Medicaid block grants (which could result in deficits and service reductions), and let states reduce funding to hospitals that serve low-income populations. Trump also supports Paul Ryan’s “A Better Way” health policy plan, which would make Medicare more expensive for seniors.

Trump poses a major threat to women’s reproductive rights. His change to the Title X family planning program has made it harder for women—particularly low-income women—to access vital preventative health services as well as abortions; this spurred a petition from the American Medical Association (AMA), Planned Parenthood, and the American Civil Liberties Union (ACLU). Trump is vocally pro-life; conversely, Biden wants to make the Roe v. Wade (1973) ruling “the law of the land.” Planned Parenthood is endorsing Biden because he advocates for access to basic reproductive health services.

Section 1557 of the ACA made it illegal for health practitioners or insurers to discriminate against patients because of their sexual orientation or identity. In June 2020, Trump dropped that prohibition, resulting in reduced healthcare access for members of the LGBTQ+ community. Biden condemns this action and pledges to expand access to quality healthcare for LGBTQ+ people.

A series of anti-immigration policies and human rights abuses at Trump’s detention centers along the Mexican border have made many immigrants mistrustful of the American government. Trump’s public charge rule discourages immigrants from seeking health services: if they use public benefits, they will likely be denied a visa or green card. Although they allegedly will not be denied COVID testing or treatment, undocumented immigrants are afraid. In an open letter to the Trump administration, American public health and legal experts emphasized that if healthcare facilities are immigration enforcement zones, both individual and public health will suffer. Contrastingly, Biden wants to reverse the public charge and end prolonged detention.

Trump’s reversal of hundreds of environmental regulations will hurt disadvantaged populations the most. He has reduced air and water quality standards, allowing major industrial polluters to emit more toxic substances. Impoverished and non-white Americans are more likely to have health issues related to coal pollution.

Trump has also removed limits on greenhouse gas emissions, which worsen climate change. This will increase the severity of storms, droughts, and fires. Natural disasters can cause immediate injury and death, hinder healthcare access, and contaminate communal water supplies. The impoverished typically have the hardest time recovering from extreme weather events. Worsening heat waves will increase instances of heat stroke and heart attacks; outdoor workers and people without air conditioning are at disproportionate risk. For the first time ever, Science American is endorsing a candidate, Joe Biden, because he has scientifically-sound plans to handle COVID and reduce emissions to the benefit of public health.

Donald Trump has expressed no interest in tackling social determinants of health or mending health disparities, and rather, he has made it harder for vulnerable populations to get the healthcare they need. Some have already experienced negative mental health effects since his term began. His re-election would undoubtedly impact the mental health of the people who are affected by his health policy decisions: those who cannot afford or access the healthcare services they need, whose voices are not being heard, whose rights have not been championed. Joe Biden will address American health inequity and promote public health. And thus, we must support Joe Biden in the upcoming election to protect the health of all Americans.

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