From the ACA to abortion, Republican presidential candidates Donald Trump and Nikki Haley are confronting some of the most contentious healthcare topics and programs. Let’s take a look at what each of their potential presidencies might look like. 

• Donald Trump
  1. Abortion
  2. Public Health 
• Nikki Haley
  1. Gender-Affirming Care
  2. Abortion
  3. The ACA
• The Long and Short of it

Donald Trump

Once again, Trump is on the campaign trail, promising, among other things, to repeal the increasingly popular ACA, and replace it with something “much better…than Obamacare,” which he considers “a catastrophe.” Here are some more of his track records in the healthcare sphere:

Abortion

Trump’s most major contribution to abortion policy, the appointment of three Supreme Court justices instrumental to overturning Roe v. Wade in the Dobbs decision, was indirect. Make no mistake, however: Trump still enacted multiple anti-abortion policies. 

During his administration, he reinstated the “Mexico City Policy,” which barred federal funding to international organizations promoting abortion rights, and cut Planned Parenthood and other abortion-providing organizations from Title X, the federal government’s family planning program. He also made it easier for healthcare providers to decline to participate in procedures and activities that they deemed to violate their religious and moral beliefs. All of these policies have since been overturned by the Biden administration.

In contrast, Trump, since leaving the presidency, has denounced the Dobbs decision as politically bad for Republicans, and has gone as far as to criticize Ron DeSantis for signing a six-week abortion ban. Despite this, he has also made more recent amends with key anti-abortion players, many of whom backed his 2016 campaign. Though he promised to broker a compromise for “both sides,” promising “an issue that we can put behind us,” he is exceptionally unlikely to advocate a pro-choice perspective during his potential presidency. 

Public Health 

The COVID-19 pandemic dominates Trump’s public health record. He publicly clashed with his top officials on the administration’s response to the pandemic, which produced a slower result in producing a diagnostics test than other governments, as well as Trump’s own hospitalization after personally flouting safety protocols. 

Despite what the Select Subcommittee of the House of Representatives called a “reckless politicization of the pandemic,” Trump eventually signed a massive COVID relief bill he threatened to veto, and oversaw the greatest boost in funding for the National Institutes of Health since the turn of the century. His administration’s “Project Warp Speed” also oversaw the creation of the novel mRNA-based vaccines for COVID-19, which lays the potential groundwork for curing other diseases, including cancer. 

Despite his achievements on paper, his reckless personal comments, public disagreement with public health officials, and political opportunism make a Trump presidency a grim sight for many in the face of another public health crisis. 

Nikki Haley

South Carolina’s governor from 2011 to 2017 has come to be known, along with Trump, to be one of the Affordable Care Act’s loudest critics, which raises concerns over her plans for potential healthcare policies. She also loudly condemns Biden’s “excessive” spending and the current Medicare deficits. Let’s take a look at the rest of her stances on healthcare. 

Gender-Affirming Care

Haley has made a point of her negative stance on gender-affirming care. “I have always said that boys need to go into boys’ bathrooms, girls need to go into girls’ bathrooms, that we shouldn’t have any gender transitions before the age of 18,” she said. “Just like we don’t have tattoos before the age of 18, we shouldn’t have gender transformation or puberty blockers.”

Abortion

Haley, on the one-year anniversary of the Dobbs decision, called the overturning of Roe v. Wade a “victory for life and democracy.” This aligns with a bill she championed as the governor of South Carolina that banned abortion procedures after 20 weeks. 

She also indicated that she would sign a national abortion ban bill if it were to pass in front of her as president. During the Iowa debate, Haley called herself “unapologetically pro-life.” 

The ACA

Despite being later cleared of any wrongdoing, Haley came under scrutiny over an advisory board meant to decide the fate of South Carolina’s healthcare marketplace when an email written by her, which read that the “whole point of this commission should be to figure out how to opt-out and how to avoid a federal takeover, NOT create a state exchange,” was leaked. 

Her time in office has been regularly punctuated by calls to repeal and replace the ACA, though she has not yet given a definitive answer as to whether she would pursue this option as president. 

The Long and Short of it

Though Trump and Haley agree in many areas, particularly around the Affordable Care Act, they remain equivocal on many healthcare issues. Both have remained unclear on what concrete actions each would take should they ascend to the presidency.