On Tuesday, August 11, 2020, presumptive Democratic presidential nominee Joe Biden announced Sen. Kamala Harris (D-CA) as his vice presidential running mate. Since joining Congress in 2017, Sen. Harris has largely served as a bridge between progressive and moderate Democratic positions and policies. She has made immigration, equal pay and reproductive health rights core planks of her policy proposals. Her current congressional committee assignments include Senate Judiciary, Homeland Security and Governmental Affairs, Intelligence and Budget.
Healthcare consistently ranks as a top priority for voters, and in the midst of an infectious disease pandemic we expect the focus on healthcare to intensify over the coming months. Healthcare also served as a differentiator in the crowded Democratic presidential primary; while all of the candidates supported universal access to health insurance coverage, policy solutions to achieve that goal ranged from creating a single-payer system to maintaining the current employer-based approach while providing a robust public option. As a candidate for president, Sen. Harris’s proposal embraced an eventual “Medicare-for-All” system buoyed by private insurance options and instituted over a 10-year transition period. Vice President Biden’s healthcare plan builds on the Affordable Care Act (ACA) by making current premium tax credits more generous and creating a public insurance option available to all Americans.
Although Sen. Harris will ultimately support Vice President Biden’s policies, her record as a prosecutor, the Attorney General of California and as a senator will influence the campaign and decisions made in the White House, if elected on November 3, 2020.
Sen. Harris is a sponsor or co-sponsor of 85 pieces of health-related legislation in the Senate. While the majority of measures are focused on reducing drug prices and expanding health insurance through public plans, she also supports health workforce training programs and insurance coverage for certain medical conditions.
Sen. Harris’s most prominent healthcare legislative priority is focused on maternal mortality. Earlier this year, she introduced the Black Maternal Health Momnibus Act of 2020. The legislative package comprised of nine individual bills, each sponsored by Black Maternal Health Caucus Members, would improve data collection on social determinants of health and invest in community-based organizations that are undertaking efforts to improve maternal health outcomes. Sen. Harris also sponsored the Maternal Care Access and Reducing Emergencies Act and co-sponsored the Healthy Maternity and Obstetric Medicine Act and the MOMMIES Act. Health disparities will likely be a major focal point in the next Congress, particularly given the disparate impact of the coronavirus disease 2019 (COVID-19) on minority populations.
Health Insurance Coverage
Early in the presidential primary, Sen. Harris’s stance on health insurance coverage was unclear. After becoming a senator in 2017, one of her first acts in office was adding her name as a co-sponsor to Medicare-for-All legislation led by Sen. Bernie Sanders (I-VT). After months of scrutiny, Sen. Harris modified her stance in late July 2019. Dubbed “Kamalacare,” her new plan would have expanded the Medicare program to everybody over 10 years with the option to enroll in private insurance plans modeled after the Medicare Advantage program. The plan appeared to split the difference between primary voters who supported Sen. Sanders’s government-run insurance proposal and Vice President Biden’s idea of maintaining the role of private insurance while creating a government alternative. In recent months, she has largely avoided the health insurance debate, focusing instead on issues such as maternal mortality among minorities and racial disparities in COVID-19 cases.
In keeping with her focus on healthcare inequities, Sen. Harris introduced the COVID-19 Racial and Ethnic Disparities Task Force Act in late April. Under the legislation, the task force would bring together healthcare and other policy experts, community-based organizations, and federal, state, local, tribal and territorial leaders who would collect and report data on patient outcomes including hospitalizations, ventilation and mortality, disaggregated by race and ethnicity. Communities with high disparities would be identified, and the task force would make weekly recommendations to the Federal Emergency Management Agency (FEMA) and Congress on how best to allocate scarce COVID-19 resources like PPE, ventilators, testing kits, testing supplies and vaccinations.
In July, Sen. Harris introduced the COVID-19 Bias and Anti-Racism Training Act of 2020, which would appropriate US$100 million in fiscal years 2020 and 2021 for the purpose of supporting bias and anti-racism training to healthcare professionals in an effort to reduce racial and ethnic disparities in COVID-19 testing, treatment, health outcomes and vaccine access.
Sen. Harris also supported many of her colleagues’ position on insurance coverage during the pandemic. She is a co-sponsor of the Stronger Medicaid Response to the COVID-19 Pandemic Act, which would provide Medicaid coverage for treatment, hospitalization, drugs and vaccines for individuals with COVID-19 who are uninsured. In addition, she voted for the Families First Coronavirus Response Act (P.L. 116-127), which mandated coverage of COVID-19 testing.
Finally, Sen. Harris has co-sponsored the Masks for All Act, which would appropriate US$5 billion for domestic manufacturing, procurement and mask distribution of reusable facemasks. The legislation would also require the distribution of three reusable masks via the US Postal Service to every American at no cost. Additional masks would be available at locations providing essential services, such as post offices, pharmacies, schools and public transportation stations.
Her support for these measures helps to identify tangible healthcare priorities she will likely support if elected as vice president.
Sen. Harris has been highly critical of the pharmaceutical industry over her career, with a particular focus on opioid manufacturers. As California Attorney General, she led the charge with Attorneys General from 34 other states to bring an antitrust action against Indivior, a British pharmaceutical company, and MonoSolRX, an Indiana pharmaceutical film technology company. The suit alleged that the two companies engaged in a “product-hopping” scheme to block the generic opioid-treatment drug Suboxone from coming to the market. As California’s Attorney General, she also oversaw the state’s prescription drug monitoring program, and during her tenure, she obtained more than US$230 million in settlements with pharmaceutical companies.
Sen. Harris’s drug pricing reform plan suggests utilizing an international price index to reduce the cost of prescription drugs. Vice President Biden has also supported that approach. Under the proposal, drug companies would be prohibited from selling a medicine in the US for more than 100% of the average price that it was being sold for in other countries that are part of the Organization of Economic Cooperation and Development. The plan would also prohibit drug companies from using advertising expenses as tax write-offs. She has also supported the safe importation of drugs from other countries.
Early last year, Sen. Harris introduced the Forcing Limits on Abusive and Tumultuous (FLAT) Prices Act of 2019, which would reduce the five- to 12-year exclusivity period by 180 days for a drug whose price increases more than 10% in a year, or similar amounts over a multiyear period. Sen. Harris said the bill would prevent “an abuse of the patent system” and “level the playing field between consumers and pharmaceutical companies.”
Ultimately, as Vice President Biden’s running mate, Sen. Harris will advocate for his policies and platforms. Her positions, particularly those strongly held, can help influence Biden’s policies during the campaign and beyond.