With rare exceptions, early voting began across the United States before Election Day on November 5. We’re offering an additional newsletter to inform you of the health care stakes as you head to the polls. We also offer a 40% discount on an annual subscription to STAT+.

What if Harris wins?

The Affordable Care Act and the Inflation Reduction Act, both passed exclusively by Democrats, forms the foundation of Vice President Harris’ health care platform. It plans to rely heavily on both to maintain high levels of insurance coverage and to keep insurance affordable.

They advocacy for reproductive health services and the focus on maternal mortality sidelined her, even among Democrats.

However, she added political planks to that platform during her brief presidential campaign. Her first new proposition was to cancel billions of dollars in medical debtwhich could be a good for hospitals.

Harris proposed expand Medicare price negotiation to fund new home care, vision and hearing benefits in Medicare.

And she wants to extends drug price reforms beyond Medicare to people who get health insurance through work.

Drug manufacturers are not the only target of drug price reform. And she wants to goes after drug middlemenwhich would benefit drug manufacturers.

Who to Know in a Harris Administration

STATE make a list of 10 people that have helped shape Harris’ positions and could continue to be influential if he wins the election.

Some of Harris’ important relationships go back several years. She has known Sen. Laphonza Butler (D-Calif.) since before Harris became California attorney general, when Butler led a union for home care workers. Others, like billionaire business mogul Mark Cuban, have arrived on the scene much more recently.

If Trump wins?

Former President Trump is harder to predict than Harris. During the debate against Harris, he said he had a “plan concept” to replace the Affordable Care Act. After a some attempts to clarify this statement by fellow candidate JD VanceTrump said they would probably keep the ACA.

Trump appears to be building a health care platform that is based on combating chronic diseases in ways that avoid insurance and conventional medical treatments.

Some of the GOP the most divisive policies against immigrants and transgender people were incorporated into Trump’s healthcare platform.

However, abortion is one area where he has tried to be less divisive softening his stance on the national ban on abortion — though he still boasts that he shaped the Supreme Court that overturned federal protections against abortion. Trump also dropped his most aggressive attack on the drug industry when he rejected his proposal to lower prescription drug prices by tying them to overseas prices. However, House Speaker Mike Johnson (R-La. ) said Tuesday that the GOP has a plan for “massive reform” of the ACA if Trump wins.

Who to watch in Trumpworld

Trump’s interest in chronic diseases created an opening for Robert F. Kennedy Jr. and a group of like-minded people to get closer to Trump. They promote a vague health care agenda they call “Make America Healthy Again.”

Trump has promised to give the vaccine skeptic a role in his administration, much to the concern of the industry. Trump did not say what that position would be, but at his Madison Square Garden rally in New York on Sunday, he said he would let Kennedy “go wild because of his health. I’ll let him run wild with the food. I’m going to let him run wild with meds.”

There are even more people from his previous administration which could turn for a second.

What to expect from Congress

Congress could have a big hand in shaping health policy after the election, as many of Trump and Harris’ proposals would require lawmakers’ cooperation. And yet, many more the policies Congress is expected to deal with during the lame duck session and next year don’t rise to the level of being part of either candidate’s health care platforms.

Some also do not depend on the control of either party. For example, anti-China sentiment is pervasive in both parties and could push Congress to pass legislation aimed at affecting China’s biotech industry. Instead, both parties advocate that Medicare continue to cover telehealth services.

But next year’s fight over expanded Affordable Care Act subsidies and Trump’s 2017 tax cuts, both of which expire at the end of 2025, will depend on who controls Congress and the White House.

What’s happening in the states

Residents of more than a dozen states are voting on health issues which include abortion, psychedelic drugs, long-term care and medically assisted suicide.

Abortion figures prominently among the ballot measures. Ten states have abortion initiatives on the ballot, the most since the Supreme Court overturned Roe v. Wade in 2022.

A handful of states with health care ballot initiatives also have key Senate races that could determine which party controls that chamber. Among the most interesting is Montana, where voters could approve a measure to protect access to abortion while electing anti-abortion Republican candidate Tim Sheehy over incumbent Democrat Jon Tester.

California has an interesting mix of seemingly unrelated ballot measures. After controversial longtime AIDS activist Michael Weinstein got a rent control measure on the ballot, apartment builders launched a ballot initiative that would undermine a drug rebate program that is a key revenue generator for Weinstein’s AIDS clinics.

From the archive