Trump, Harris on Abortion: Reporters’ Roundtable Examines Their Records

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Mark Masselli ( 00:04 ):
Healthcare is on the ballot this presidential election cycle, the first one since the Supreme Court ended
the constitutional right to abortion. Former President Donald Trump and Vice President Kamala Harris
understand that abortion and other health policy issues are on voters minds like never before.

Shannon Firth ( 00:23 ):
Her speech at the DNC outlined what she felt that he might do. She said that Trump would limit access
to birth control, ban medication abortion, create a national abortion anti-abortion coordinator who
would then track pregnancies and miscarriages and abortions. All of these are ideas that are outlined in
Project 2025.

Margaret Flinter ( 00:47 ):
Joining our Reporters Roundtable are the journalists who cover and analyze these issues. Shannon Firth
is the Washington correspondent for MedPage Today. Ben Leonard is a healthcare reporter for Politico.
And Sarah Owermohle is a Washington correspondent for STAT News.

Sarah Owermohle ( 01:04 ):
Trump has talked to plenty about how he wants to improve ACA and how he won't repeal it unless
there's something much better. What is much better? Specifically, what is much better? So, not just the
subsidies question, but what would you do to ACA to make it much better?

Margaret Flinter ( 01:17 ):
This is Conversations on Healthcare.

Mark Masselli ( 01:27 ):
Well, we want to thank you all for joining us on Conversations on Healthcare. My God, the world has
changed in the last 30 days. We were covering one election, now we're covering another. And both of
the conventions are over.... We're really in the final weeks of this historic presidential race. Shannon,
would like to start with you. One of the most striking parts of Kamala Harris's accepting speech was
about Donald Trump and the additional limits she says he'll pursue on abortion. Do you think Harris
successfully explained the contrast?

Shannon Firth ( 02:05 ):
First of all, thank you so much for having me, Mark. I want to say yes. I think she did effectively lay out
the contrast between herself and a future President Trump. Her speech at the DNC outlined what she
felt that he might do. She said that Trump would limit access to birth control, ban medication abortion,
create a national abortion anti-abortion coordinator who would then track pregnancies and miscarriages
and abortions. All of these are ideas that are outlined in Project 2025, and while Trump has tried to
distance himself from that plan, the blueprint that the Heritage Foundation laid out for the next
Republican administration. All of that may seem like a stretch, but if you look at what a prior Trump
administration has done, that's the biggest indicator, experts tell me, of what a future administration
would do.
( 03:03 ):

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And during his own past administration, he chose three Supreme Court justices who reversed or
[inaudible 00:03:11] and ended the federal protection for abortion, which then led to what we have
now, which is a dozen or more states where there's near total abortion bans. He sought to repeal the
ACA, which includes requirements that employer-sponsored insurance cover birth control with no
copay. And he signed a bill that allowed states to decide whether or not they wanted to defund Planned
Parenthood. Planned Parenthood receives money from the Title 10 family planning grants, and that
money is very important to be able to help people access birth control.
( 03:50 ):
Does it sound extreme? Perhaps. But I do think he's been on the track of limiting reproductive rights for
the prior presidency, and the fact that he's been so back and forth on issues like medication abortion
and a federal fifteen-week ban. He's come down to most recently say everything should be left up to the
states, but it's very hard to predict what he would do when he waivers so much.

Margaret Flinter ( 04:18 ):
Shannon, I think one of the interesting things about the convention is that the focus on the conservative
policy document, Project 2025, really broke onto the national scene, it seems to me, pretty not so long
before the convention that this became a front and center topic with, as you say, called for a national
anti-abortion movement really. You talk about support in the Trump camp. Do you think that there's the
same level of support in Congress for these ideas? And what would you identify as maybe another top
two things in Project 2025 that are going to really be front and center for the rest of the campaign?

Shannon Firth ( 05:05 ):
I think that Project 2025 is important to really look at that as a true concern. I know that there are
members of Trump's former administration who are very heavily involved in that. I know that his
running mate wrote the foreword for Kevin Roberts, the president of the Heritage Foundation's next
book, which has been delayed. So, we see a lot of crossover there. In terms of support in Congress for
potential plans, I could see... We know that Senate Republicans have sought to block a law that would've
protected women who are traveling across state lines to seek abortion. So, it's not a far stretch to think
that maybe tracking those abortions and tracking those pregnancies is something would be on their
radar.
( 05:59 ):
I think it would be up to, really, the next Congress to see what the makeup of the next Congress is to
decide whether something like that would happen. As far as other dangers in that plan, I mean, the plan
to basically choose new civil service workers, essentially, who are aligned with Trump could have a huge
impact. I mean, there are so many different challenges to reproductive rights in there. It's hard to know
where to start. But renaming HHS, the Office of Life or something along those lines, just seems like there
are a lot of dangers in that plan for reproductive health and reproductive rights.

Mark Masselli ( 06:48 ):
Shannon indicated that the message came across loud and clear. But after the Democratic Convention,
the former president said on social media that, if elected, his administration will be great for women's
reproductive rights. He also said he would not enforce the Comstock Act to ban mail delivery of abortion
pills. What are voters supposed to make of these claims and counterclaims on the abortion issue? Talk a
little bit about the Comstock Act as well, just so people don't understand what this is as well.

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Ben Leonard ( 07:24 ):
Yeah. I mean, this is very in line with what Trump has done on this issue. He's likely very aware of the
polling and that Republicans are at a polling disadvantage with voters on abortion reproductive rights.
And he hasn't been afraid to try to distance himself from a lot of the anti-abortion groups that have
supported him and controversial policies that they may be pushing like enforcing the Comstock Act,
which is essentially a law from the late-1800s that would be used to ban the delivery of abortion pills via
the mail. It's the most common form of abortion now. So, Democrats are saying that's essentially a
national abortion ban. So, he's been trying to moderate his tone on this issue. And that would probably
upset some people in the anti-abortion movement and could potentially run against some of the beliefs
of people who could be in his administration.
( 08:18 ):
I mean, as Shannon mentioned, Project 2025 is called for its use, which Trump has repeatedly tried to
distance himself from. But I would say, just overall, it's hard to say exactly what the Trump
administration would do on these issues. But as Shannon was mentioning, we can see what they've
done in terms of regulation, HHS, FDA, they have a lot of tools there and a lot of people who might be in
his administration that would want to do a lot of things on that issue.

Mark Masselli ( 08:48 ):
It's kind of interesting. In his presentations, he's both saying that he's the best things in slice bread for
women's reproductive rights, but also reminding people that he appointed the three Supreme Court
justices who overturned it. I'm not sure if he's not mixing his messages or maybe he's hoping that just
people are excerpting the message they want to hear.

Ben Leonard ( 09:13 ):
Yeah. He says a lot of things.

Margaret Flinter ( 09:15 ):
Sarah, I want to pivot a bit to the issue of gun violence. In her speech in Chicago, Kamala Harris said,
"Other freedoms are at risk, including..." Quote, "The freedom to live safe from gun violence in our
schools, our communities, and our places of worship." And of course, US Surgeon General Vivek Murthy,
early this year, declared gun violence a national public health crisis. What's the significance, political or
social, of making gun violence a health issue in this campaign?

Sarah Owermohle ( 09:45 ):
It is very significant, and we've seen this growing over the past few years as more doctors, especially ER
physicians, become more vocal about the impact of gun violence, the devastation that they've seen
personally. And with Dr. Murthy putting out that public health emergency, he cited a lot of statistics
justifying it. And I think one of the most striking ones was him saying that in 2020, children's deaths from
gun violence surpassed deaths from car related injury.

Margaret Flinter ( 10:15 ):
That's right.

Sarah Owermohle ( 10:16 ):

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Yeah. Absolutely. And so, of course at the DNC, we saw a very long segment with people who had
firsthand experienced this, lost people from it. We saw former representative Gabby Gifford speak
about her experience. And reframing it as a public health issue really helps bring in this sort of human
loss and the impact that the society is seeing from this. But I think also what is significant about this, and
Harris putting it really at the forefront of the DNC and her campaigning, is that it's one of the things that
she can really point to her own record, and it can be difficult for vice presidents to distinguish
themselves from the present that they're working, but she really does have a record here.
( 10:54 ):
So in the White House, she was overseeing the... Or is overseeing the Office of Gun Violence Prevention.
As a senator, she advocated for and co-sponsored legislation to improve background checks. As an
attorney general, she joined many lawsuits, or led them herself, about gun violence and gun control. She
also advocated for red flag laws that would take guns from people who were deemed a risk. And even in
the 2020 campaign, she went even further left than Biden saying that we should do mandatory buybacks
of automatic weapons. And so, this is really an area where she can say, "I have a record here. I'm not
just the vice president of Biden."
( 11:32 ):
Of course, also it is an area that's dicey when it comes to more conservative voters or independent
voters who don't want to see more gun control. We've seen the Trump campaign already paint her as
the most far left candidate to ever be in the Democratic nomination. So, it is a tricky one for her, but I
think that's another reason why we're seeing it framed as a public health issue.

Mark Masselli ( 11:53 ):
And Shannon, America got to meet for the first time, at the Chicago Convention, Democratic Vice
Presidential candidate, Tim Walz, who shared his family's personal struggle with medical debt. And the
party's platform now says that the country should exclude medical debt from credit reporting agencies.
What would be the effect of such medical debt changes?

Shannon Firth ( 12:18 ):
That's right. When Tim Walz was introduced to the public, he really has spoken up and keyed in on this
challenge of medical debt. His own family has been affected by it. When he was 19, has father died of
lung cancer. And his mother, who was then a homemaker, had to go back to work in her 60s. So, it's a
very personal issue for him. In terms of what he's done at the state level, we've seen, as governor of
Minnesota, he banned medical providers from withholding needed care from patients who have unpaid
debt. He stopped the automatic transfer of medical debt to a spouse, and he stopped medical debt from
impacting Minnesotans credit scores.
( 13:03 ):
You asked why that is impactful, why that's important, your medical debt can lead to bankruptcy, it can
make it harder to buy a home, it can have all kinds of repercussions for your life. And the Harris-Walz
ticket really feels that that's unfair. That something like an illness could ruin your credit history, your
future is a huge injustice, really. So, I think that they will be really focused on highlighting that as a
priority, erasing medical debt, helping states to get a handle on that.

Margaret Flinter ( 13:42 ):

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Ben, I wonder, while we're on the topic of medical debt, if you'd like to comment on where the
campaigns stand on, both a separate but a related issue, and that surprise medical billing, which is just
what the name implies. But you've reported that putting more limits on surprise billing is a very popular
issue with the public. I don't remember hearing about it during the conventions. But where do the
campaigns stand on this issue?

Ben Leonard ( 14:08 ):
Yeah. It's not something that is dominating Harris's nomination speech or anything like that, but it's
something that they've been talking about a little bit, whether or not it meets the traditional definition
of surprise billing because it's a popular issue. Generally, just to level set, we think about surprise billing
as when bills come from... That insurance patients get unintentionally from out-of-network providers
that they didn't choose. And Kamala Harris has proposed, in the DNC platform, to expand those
protections to ground ambulances. And the thinking is that patients can't pick an ambulance when they
call 911, so they don't really have much choice in avoiding these out-of-network charges. A number of
states have done stuff on this with ground ambulances, but this would do it at the federal level.
( 14:54 ):
J.D. Vance and Republicans are talking about it in a different way that's not necessarily what we might
think of as surprise billing. In several TV interviews, he talked about ending surprise medical bills for
when patients go to the hospitals to have children, and they might come out with unexpected bills. He's
talking about instead of these traditional surprise bills, more this legislation that he had proposed
surrounding medical leave and healthcare premiums so that employers can't essentially claw those back
after the birth of a child if you're on leave. That's not likely to become law. There's no democratic
support. It's framing a bill in a way to potentially be more popular there and not a surprise bill in the
traditional sense that we might be talking about, with no surprise to that.

Mark Masselli ( 15:52 ):
And Sarah, you've written that Donald Trump has said that under Kamala Harris's administration, this is
a quote, "Private health insurance policies are gone, and she would start a communist system where
everyone gets healthcare under a public option." What's Trump basing these comments on?

Sarah Owermohle ( 16:10 ):
He's basing it on her record. She did, in her prior presidential campaign in 2020, endorsed a Medicare
For All plan, and she also endorsed... I mean, sorry, co-sponsored a bill with Senator Bernie Sanders
from Vermont, who was a longtime proponent of Medicare For All that would implement that plan. So
there is some basis, however outdated, and truth there. She has this campaign cycle backed away from
that. And actually, shout out to Politico, who had a pretty good article the other day about that, or the
other week, as Mark said earlier, I can't even tell what time it is anymore. But she's backed away from
that, recognizing that it is a tricky area to get into with a lot of voters.
( 16:50 ):
There's some polling that suggests that while most Americans believe that the federal government is
responsible for our healthcare coverage, nearly half of Americans, those same respondents, want to
keep their private insurance and prefer that to the idea of a public marketplace. So, she's going now
more towards what Biden or Pete Buttigieg did in the 2020 election. Pete Buttigieg called it Medicare for
All Who Want It, that's the pathway that she's choosing now. What's been interesting is that people like
Senator Sanders, who, again, has been a longtime advocate of this, are not publicly admonishing her for

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that backing away. And so, they want to project a unity here, they recognize that, now being past the
primary stage, being at a stage of her versus Trump, that she does have to back away from some of
these things.
( 17:37 ):
What is also interesting is how the Trump campaign is dealing with it. As I mentioned earlier, they've
already been painting her as the most far left candidate. So, while he's saying things like this about a
communist system that she wants implement, also people from his campaign are arguing that her
backing away from Medicare For All is alienating or betraying progressives. So, it's kind of a have your
cake and want to eat it too situation. They're calling her far too progressive, but also saying she's
betraying progressives.

Mark Masselli ( 18:05 ):
There seems to be great unity on the Democrats between the left and the right coming together.

Sarah Owermohle ( 18:11 ):
Yes, exactly. Exactly. So, that's the way that they're trying to maneuver this. And I do expect it's going to
come up a lot more. And I think she's probably going to have to explain at some point, maybe on the
debate stage coming up, what she would do if not Medicare For All.

Mark Masselli ( 18:24 ):
I hope all three of you have told the campaign you're ready to do that one-on-one interview with her.

Sarah Owermohle ( 18:29 ):
Yes. The offer is open.

Mark Masselli ( 18:32 ):
In case she's listening in.

Margaret Flinter ( 18:37 ):
Sarah, I want to ask you about something that is not talked about as often now, which is the COVID
pandemic. And while we say the COVID pandemic is over, of course we're in the middle of a resurgence
here in the Northeast right now, so it's hard to think of it as over. But you've written that its role in each
campaign's rhetoric is not over, that it's still a subject of discussion. How are people using it and what
are they putting forth to strengthen their case to the American people about why they should be
president?

Sarah Owermohle ( 19:09 ):
Right. Yeah. As you said, it's not over in the sense that COVID is gone, but the emergency measures, the
way that the federal government has even funded some of the response, that part of it is over. And so, I
was actually a little bit surprised how much it came up at the Democratic National Convention because
that's an opportunity to highlight victories, positivity, and a lot of people don't want to talk about COVID
anymore. But the way that the Democrats are using it, and the Republicans, is not so much about
healthcare on its own, but how each of these leaders handles an emergency and the ways that impacts
the economy, the way it impacts children's learning and welfare, the way it impacts people's trust in

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public institutions and healthcare experts. And then, the lingering effects that we're having with vaccine
confidence and misinformation.
( 19:55 ):
And so, the reason that I think it's not going away is because, at least for Trump, he's arguing, from the
economic perspective, that Democrats went too far and they hobbled our economy, hobbled our
children's sociability and learning, and they beer mongered in a way, which is some of the terminology
that he and his campaign has used. The way that Democrats are using it is saying that he underplayed it
and he promoted misinformation, and now we're dealing with the effects of people not trusting public
health experts. Another way I think that this is not going to go away, and in fact is going to grow as an
issue, is that Robert F. Kennedy Jr. recently endorsed Trump and said that he would like to have a public
health role in a next Trump administration.
( 20:36 ):
And as we know, Robert F. Kennedy has questioned the safety of vaccines, particularly the COVID
vaccines, which he called the most dangerous. And both he and Trump have more recently been
questioning whether the rise of chronic diseases, including autism, which we know it's been disproven
that that is linked to vaccines, but they're raising that issue again, trying to link that to vaccines and
saying that the amount of vaccines that children are having now is somehow correlated to chronic
health issues. So, we're not going to see this issue go away.

Mark Masselli ( 21:08 ):
No. I think people have wanted to put it in the rearview mirror, it's not going away. We see the spike, as
Margaret indicated, as well. The vaccine is now available, so there'll be a lot of public conversation
about that. Shannon, I think Americans might be surprised at this number, that private companies offer
Medicare Advantage plans, and they account for about 54% of the eligible Medicare population. I'm
wondering if you could tell us about the changes a Trump or Harris administration could pursue for
Medicare Advantage.

Shannon Firth ( 21:40 ):
Thank you. That's a great question. I think that, in terms of Medicare Advantage, yes, it is growing. And
as it grows, I think there's been a lot more attention on some of the challenges and flaws in the
program. I will say, as Attorney General Kamala Harris really took on insurers, drug companies, big
pharma really sought to protect and fight for accountability among these big corporations. And I think
she'd continue to try to... As president, if elected, I think she would seek to continue that approach and
really investigating what's going on behind the veil here. Because Medicare Advantage has been shown
to follow some practices that seem to be unethical, upcoding, using prior authorization to limit care and
services using algorithms. I know STAT had some great reporting on insurers using algorithms to prevent
people from getting care through prior authorization. Basically, trying to make people look sicker than
they are, give them services they don't need and rake in more money. And I think that's not something
that a Walz-Harris administration would want to see continue.
( 23:04 ):
The GOP has traditionally been pretty supportive of Medicare Advantage, but I heard from former HHS
secretary, Alex Azar, that there is a modern populist part of the Republican Party that is not so
enthusiastic about Medicare Advantage sees it as corporate welfare. And while Azar himself is still very
supportive and thinks that some of the reporting and some of the government analysis that look at
Medicare Advantage are flawed. For example, there is a government analysis from MedPAC, the

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Medicare Payment Advisory Commission, which has stated that Medicare Advantage costs Medicare
22% more than traditional Medicare for enrollees. There's a lot of conservatives that question that
report. But it's findings like those that are driving the criticism of those plans and the need for more
investigation and perhaps more regulation of those plans.
Margaret Flinter ( 24:05 ):
I think we're going to be hearing a lot more about Medicare Advantage in the coming months. So, we
may come back to you for further conversation on that.
Mark Masselli ( 24:13 ):
Well, the presidential debate is set for September 10th, or maybe it's not. Maybe the mics will be on,
maybe the mics will be off. But if the mic was on for each one of you, what would be the healthcare
question you'd like to pose to the candidates? Shannon.
Shannon Firth ( 24:28 ):
I would ask the candidates about the ACA's enhanced subsidies. Those are subsidies which expanded
access to middle-income Americans to be able to afford health insurance on the exchanges, and those
are expected to sunset at the end of 2025. I'd ask whether they plan to extend those subsidies. And if
those subsidies are not... Are allowed to expire, then what would be your plan for ensuring that we
don't see a surge in the uninsured rate of Americans?
Mark Masselli ( 25:01 ):
Great. Sarah.
Sarah Owermohle ( 25:03 ):
Yeah. I would add onto that one, and then have another, if I may. Just a broader-
Mark Masselli ( 25:07 ):
You're a White House reporter, it sounds like. Get a second question.
Sarah Owermohle ( 25:12 ):
But to put a broader point on what Shannon just said, Trump has talked plenty about how he wants to
improve ACA and how he won't repeal it, unless there's something much better. What is much better?
Specifically, what is much better? So, not just the subsidies question, but what would you do to ACA to
make it much better? And then, just another one is Medicaid. We haven't talked about Medicaid at all in
either campaign. And we know, from the first Trump administration, that they implemented work
requirements for some states, they explored block grants, which changed the funding structure and
keep funding flat. And so, we just have not talked about Medicaid at all.
Mark Masselli ( 25:43 ):
And it was up to 90 million Americans. I know it's dropped with redetermination. Ben, what was your
question?
Ben Leonard ( 25:53 ):

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Yeah. I think I'd have one for each of them. For Trump, I'd ask about the drug pricing negotiations under
Medicare, what he thinks about that, because he hasn't been necessarily clear. And then, Harris I would
ask about her previous stance on Medicare For All and what changed.

Mark Masselli ( 26:07 ):
Any thoughts amongst the three of you whether or not there'll be a debate?

Sarah Owermohle ( 26:15 ):
I'm not a betting woman, and when it comes to the debate, whatever I say will be wrong.

Shannon Firth ( 26:23 ):
I'll say I think there will be, but I don't know for sure. We'll see.

Ben Leonard ( 26:24 ):
Yeah. I know they've happened most years. Tend to happen, but there are some fights going on right
now. So, we'll see.

Margaret Flinter ( 26:32 ):
Well, the one thing we can probably be sure of is all of us will be watching and listening if there is. And
as we look to the future, it's early to begin speculating about who could serve in a cabinet. But we did, a
little bit earlier when we were talking about Robert Kennedy having expressed interest in serving as
Health and Human Services Secretary, and Ben or Shannon or Sarah, who are some of the other HHS
contenders on each side? I assume that kind of competition is already underway. Who do you think they
are? And what would they mean for our healthcare system?

Sarah Owermohle ( 27:08 ):
Looking to other conservative think tanks that aren't Heritage, since Trump is a bit on the outs with
Heritage right now. So Paragon, American Enterprise Institute, America First Policy Institute, a lot of the
people that staff those organizations like Heritage are former Trump officials. I would say, on Roger
Severino, he was the primary author on the health section of Project 2025, where Shannon mentioned
earlier. There were a lot of pretty out there ideas on having an abortion coordinator, on setting up anti-
abortion measures. I think recognizing now how deeply unpopular that is with voters and struggling to
distance himself from that. I don't think we'll see Severino's name come up anytime soon in a real way
with Trump, but maybe a year or two into administration, we'll see him pop up.

Shannon Firth ( 27:51 ):
Yeah. I think that Eric Hargan, maybe Brian Blaze. Brian Blaze has been very vocal about ways that he
thinks the ACA needs to be reformed and concerns that he has in terms of subsidies being misused,
essentially. So, I think that there's definitely room for a lot of those voices in a Trump camp.

Mark Masselli ( 28:13 ):
You and we are very much focused in on policy, but the question is, is America... There's a lot of talk
about this being a vibe election, which is short on policy discussions. What's your sense? Given the short
time that we have, you think policy will find its way to the American public?

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Ben Leonard ( 28:35 ):
I think they'll point to it, but there's not going to be detailed plans out there. Just [inaudible 00:28:40]
the DNC, there was a lot of gesturing the policies, but not a lot of actual specifics on that. So, same in
the platform for both parties.

Sarah Owermohle ( 28:51 ):
Yeah. I think one of the difficult things is, once again, just the way that Democrats are using Project 2025
and then what the truth is of those intentions that Trump actually has. We can probably consider that
many things. I mean, it's a 900-page document. We can probably consider some of those things to be
realistic, but then others, like a national abortion ban, just simply not feasible. And other Republicans
have said that as well. So, some of those things are red herrings.
( 29:13 ):
And then, on the Democratic side, Harris is charting out things that certainly are popular like what was
mentioned earlier with erasing medical debt, but without detail of how that's going to be paid for and
the machinations that need to happen with state governments, with hospital industries to get that done.

Shannon Firth ( 29:29 ):
I don't think voters are necessarily unlike reporters and health policy experts really digging into the
details of all these plans, but I do think that stating clearly what their views are, where they stand on
things like abortion, medical debt, gun violence, I think that's all important to the campaign. I do think
there's a lot of other factors that will matter, charisma, running mates, anything else that should come
out, any quotes that should come out in the next few weeks that people have said in past years. So,
there's a lot that can happen in this short time.

Margaret Flinter ( 30:08 ):
A very short time indeed, but something we are all hyper-focused on. And I want to thank each of you
for joining us. Shannon Firth with MedPage Today, Ben Leonard with Politico, and Sarah Owermohle
with STAT News. And thanks, of course, to our audience for being here. Be sure to subscribe to our
videos on YouTube, find us on Facebook and X with our account name CHC Radio. And as always, you
can go online to chcradio.com, sign up for email updates. And also, please share your thoughts and your
comments about this program. Thanks to each of our guests today for being with us.

Speaker 1 ( 30:45 ):
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