The upcoming November election will have a significant impact on health care nationwide. Policy proposals championed by candidates at the federal and state levels could radically change health law and policy in ways that will reverberate in 2025 and beyond. In this new blog series, the experts at NHeLP will analyze and discuss how various policies would positively or negatively impact access to care for millions of low-income people, people with disabilities, Black, Indigenous, and people of color, LGBTQI+ folks, pregnant people, and those who live at the intersection of those identities. Follow along with NHeLP through Election Day as we explore opportunities and threats to health care in the United States.
It’s hard to predict what will happen in the November elections. Who will be President; who will control the House and Senate? Will elected state leaders be committed to ensuring that their people have access to necessary health care? How will this new mix of power play out for low-income people, for people who face discrimination in access to essential health care?
At the National Health Law Program (NHeLP), we are planning for a number of possible outcomes, including serious threats that may come quickly and opportunities that may be fleeting. Throughout the fall, we will be publishing a series of thought pieces that will outline threats we are preparing to defend against and opportunities we will be ready to take advantage of, based on what we have experienced in the past, on policies and goals that have been identified in publications like Project 2025, and on the collective thinking of NHeLP and our partner organizations.
I would like to share a few thoughts as I introduce this series. One is that we have been here before. NHeLP has been working for more than 55 years to ensure access to health care, to advance toward health equity and to enforce civil rights. We have protected and helped expand Medicaid through many different federal and state administrations. We have been instrumental in shaping Medicaid law and policy to provide more and better care and to give teeth to laws forbidding discrimination. We have fought past efforts to balance budgets at the expense of low-income and underserved people with little political clout. We have used the courts to stop government actions that violate the Constitution and our laws.
We will do it all again if we need to – we will resist fiscal schemes, like per capita caps and block grants, that would gut Medicaid and essentially ration health care spending. We will resist work requirements and other obstacles that are built on the anti-worker lie that low-income people don’t work hard enough. We will resist discrimination, even when couched as “religious liberty,” because discrimination in health care is wrong and illegal and can have deadly consequences. We will counter efforts to strip funding and consumer protections in the ACA and roll back federal oversight of the Medicaid program.
We have been here before and yet far-right policy proposals, like those found in Project 2025, are breathtaking, both in the scope of their plans to limit access to health care and by the brazenness of the assertion of power to execute the plans, including through the mass firing of nonpartisan civil servants and policy professionals at agencies such as the U.S. Department of Health and Human Services, and through the implementation of a policy agenda by executive fiat. We may even see efforts to withhold funding from states that don’t tow the administration’s policy line and instead dare to provide reproductive health care and gender-affirming care, or to provide health care to immigrants.
We will use the same strategies and strengths to take advantage of opportunities to advance toward the health equity that is our north star. We hope to close Medicaid gaps, strengthen services for people with disabilities, ensure that our children have the health care to thrive, improve data collection to address health inequities, guarantee sexual and reproductive health care that does not stop at state borders, and better protect individual health rights.
Through this series, we will be pleased to share with you in greater detail our insights into the threats and opportunities we see ahead. We’ll also be laying critical groundwork for protecting Medicaid, by ensuring that policymakers and advocates understand how Medicaid works and why it matters so much to 80 million people across the country, to children, people with disabilities, people of color, pregnant people, people who need access to sexual and reproductive health, and seniors. No matter what happens in November, Medicaid will remain essential to our collective future, because our country will be strong only if everyone has the health care they need to thrive.
We cannot predict exactly what we will see when the dust settles in November, but we are ready. NHeLP will marshal all of our strategies and strengths, including education, advocacy, enforcement and litigation, in order to protect the people whose access to health care depends on us. Threats and opportunities may differ state by state, and other threats and opportunities will be national in scope. In either case, NHeLP is prepared, with deep relationships with both state and national partners, to quickly identify threats and determine the most effective methods of resistance and to seize opportunities to move toward the goal that so many of us share, that everyone in this country will have the health care and other resources they need to thrive.
