Expected Democratic presidential nominee Kamala Harris has been an outspoken proponent of abortion access and maternal health during her time in Washington, but her Senate record demonstrates a wide range of health policy passions, from telemedicine to enforcing consumer protection laws.
“I spent my entire career fighting to protect consumers and lower medical bills for families,” the vice president said in a call with reporters last month, citing protecting the 2010 health care law and blocking health care industry mergers as among her greatest health care accomplishments.
Harris, a former California attorney general who represented her state in the Senate from 2017 to 2021 before becoming vice president, is likely to carry the Biden administration’s mantle forward in her presidential campaign, said Larry Levitt, executive vice president for health policy at KFF.
“I would expect Harris to largely continue the health care agenda set out by Biden, with greater emphasis on abortion rights and issues she has taken the lead on, such as medical debt,” he said in an email.
But her prior experience is instructive: In the Senate, Harris spent much of her time focusing on mental health, telemedicine and drug pricing.
Harris was an early proponent of telehealth — even before the COVID-19 pandemic.
In the Senate, she introduced legislation that would make it easier for Medicare beneficiaries to receive mental health telehealth services and to help mental health professionals repay their student loans faster. Although neither of those bills advanced out of committee, Congress has eliminated restrictions on telehealth coverage through the end of 2024, and lawmakers are considering making the changes permanent.
Harris also led Senate efforts to curb racism among health care workers and reduce racial disparities in COVID-19 outcomes. She introduced two bills to increase non-bias training for health care providers during the pandemic and track race and ethnicity data when it came to COVID-19.
She focused much of her Senate health policy work on maternal health — especially Black maternal health, as Black women are two to three times more likely to die of pregnancy complications than white women, according to data from the Centers for Disease Control and Prevention.
During her time in the Senate, she introduced several bills aimed at curbing the maternal mortality crisis in the United States, most notably as a co-sponsor of the “momnibus” measure, a package of 13 bills aimed at improving maternal health, with a focus on Black women.
Several of the package’s provisions, including grant programs for training and research, were later included in President Joe Biden’s domestic policy package passed by the House in 2021, but the “momnibus” provisions were omitted from the final law.
In 2022, as vice president, Harris announced a nationwide Blueprint for Addressing the Maternal Health Crisis. She played a key role in the Biden administration’s push for states to expand Medicaid postpartum coverage from two to 12 months, creating “birthing friendly” hospital designations and launching the maternal mental health hotline (1-833-TLC-MAMA).
When she ran for the Democratic Party’s 2020 presidential nomination, Harris co-sponsored Sen. Bernie Sanders’ “Medicare for All” bill before introducing her own version that included private insurance. The walk-back was met with criticism from progressive voters.
Health care costs
As a prosecutor, Harris was responsible for enforcing consumer protection laws, often challenging decisions made by health care providers and companies that she felt jeopardized those protections.
“She has been focused on how to improve the heath care system so it actually works for people, not just in theory but in practice,” said Jill Habig, who oversaw Harris’ health care portfolio while she was California’s attorney general.
As attorney general of California between 2011 and 2017, Harris investigated concentration in health care markets, laying the groundwork for her successor, Xavier Becerra, to challenge anticompetitive behavior by Sutter Health, one of the largest hospital systems in California, according to a 2020 Health Affairs article.
She joined other states and the Department of Justice in a lawsuit to block the proposed merger of Anthem and Cigna, two large health insurance companies, and scrutinized practices used by drug companies to extend the market exclusivity of their products.
If Harris were to become president, she would do so during a time when health care is even more consolidated and drug companies continue to maintain exclusivity on many pricey, brand-name drugs.
The Biden administration has made some moves in those areas, with the Federal Trade Commission investigating pharmacy benefit managers and consolidation in the health care industry. But a Harris administration could become more aggressive, Habig said.
“As a career prosecutor, she’s going to lean into the accountability piece: How do we make sure when setting standards for companies that there is actual accountability to follow through on those commitments so people can get what they expect from insurance companies, health care providers and drug companies,” she said.
Medical debt
The Biden administration became the first to try to address the issue of medical debt. About 15 million Americans have $49 billion worth of medical debt in collections listed on their credit reports, according to data released in April by the Consumer Financial Protection Bureau.
It has become one of Harris’ issues, with the vice president announcing in June a proposed rule that would bar credit reporting agencies from including medical debt on credit reports sent to lenders. The intent is to ensure that medical debt information is not used to make credit eligibility determinations.
“We are making it so that medical debt cannot be used against you when you apply for a car loan, a home loan or small-business loan, or something of that nature,” Harris said in a call with reporters.
Abortion
Abortion access is one of the top policy issues in Harris’ vice presidential portfolio, which Democrats view as a key electoral issue this year.
Unlike Biden, a practicing Catholic who tries to keep reproductive rights as a main-stage policy issue but has said that “he is not big on abortion,” Harris was the first vice president to visit a Planned Parenthood clinic. She spent much of her time in office crisscrossing the country to talk about reproductive rights.
Harris has gone further than Biden when it comes to abortion rights and proposed protections that would go beyond restoring the Roe v. Wade standard by limiting state restrictions. Her proposal, which she floated in 2019 while serving in the Senate, would require states with a history of limiting abortion access to get clearance from the Department of Justice.
Her candidacy has already mobilized anti-abortion groups. SBA Pro Life America has dubbed her an “abortion czar” and criticized her policy views.
“While Joe Biden has trouble saying the word abortion, Kamala Harris shouts it,” SBA Pro-Life America President Marjorie Dannenfelser said.
Abortion rights groups are already formally endorsing Harris. They include Reproductive Freedom for All and EMILY’s List, a group that backs candidates who support abortion access.
In one of her first stops on the presidential campaign trail on Wednesday, Harris vowed to sign any legislation Congress might pass to restore federal abortion protections.
“We are not playing around,” she told an audience in Indianapolis.
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