Healthcare on the ballot: what you should know before voting

The role healthcare plays in politics is an important one, and during an election year, we have the opportunity to think about how our vote can impact our health’s future. Healthcare is in the back of our minds, in the headlines, in small talk during dinner. And when it’s an election year, terms like universal healthcare, Affordable Care Act, and Medicare for All are all used more frequently in conversations around politics.

But how exactly is healthcare represented on the ballot?

The 2020 Presidential Election is within reach, and we’re voting for a lot more than the next president. When we cast a vote, we elect local, state, and federal candidates who represent our interests to advocate for change in our communities on our behalf. While questions like “Do you think all Americans should have universal healthcare?” or “Do you agree with the current insurance laws?” are never on the ballot, these are the kinds of questions lawmakers and representatives deal with on a regular basis—and they are the questions that may be worth exploring when considering your candidates.

According to the Pew Research Center, 92% of Americans rank the affordability of healthcare at the top of their lists of major issues in America, and 61% of Americans say it is the federal government’s responsibility to make sure all Americans have health insurance. But only 139 million Americans voted in the last Presidential Election—that’s barely 60% of the eligible voting population.

Voter turnout in so-called “off years” or during midterm elections is even lower. Only half of eligible voters turned out to vote in the 2018 midterms, but it was at least an 11 point increase compared to the 2014 midterm elections.

While voting works differently in every state and healthcare laws look different across the country, there are overarching healthcare issues that affect everybody.

To make sense of some of the conversations being covered in the election debates and on the front pages of the news, we decided to lay out some of the most prominent questions about how healthcare is related to voting.

What should I know about where candidates stand when it comes to healthcare?

Healthcare is woven into many areas of government and elected officials on all levels cross paths with issues related to health, including governors and mayors, judges, city council members, and state representatives. All of these positions have a hand in advocating for changes in healthcare, and you should consider researching their stance before you vote.

Visit their campaign websites, research their voting history and any public statements they’ve made regarding health and wellness, and reach out to their campaigns directly if you have more questions about where they stand.

To read more about where the presidential candidates stand when it comes to healthcare, visit The Ballotpedia and the candidate websites. Knowing each candidate’s views on issues like Medicaid and health insurance, reproductive health, and COVID-19 can give you insight into how their politics can affect you or your loved ones.

What is the Affordable Care Act and what happens if the Supreme Court dissolves it?

The Affordable Care Act, otherwise known as Obamacare, is the healthcare reform law that gives millions of Americans access to health insurance and lowers health care costs. The ACA also protects Americans with pre-existing health conditions from being denied coverage or being charged higher premiums because of their health history by insurance companies.

After a Texas judge ruled the Affordable Care Act as unconstitutional in 2018, the case made its way up to the Supreme Court and will be heard later this year. If the ACA is overturned, upwards of 21 million Americans could lose access to their health insurance—including young adults under 26 who may be covered under their parents’ insurance policy. People with pre-existing conditions could pay significantly higher insurance premiums or lose their coverage altogether. This is especially dangerous during the pandemic as anyone who has been infected with COVID-19 is categorized as having a preexisting condition, and could therefore lose protection from insurance discrimination under this law.

Politicians across parties take different stances on the issue, and it will really come down to the decision of the Supreme Court. However, after Supreme Court Justice Ruth Bader Ginsburg’s recent passing, the open seat on the highest court may either be filled by President Donald Trump before the November election, or the next president-elect, and could swing the outcome of the vote.

How do racial and ethnic disparities relate to healthcare issues?

In the words of the Center for American Progress, “The United States is home to stark and persistent racial disparities in health coverage, chronic health conditions, mental health, and mortality.” Similar to other public interest categories like education, housing, and the economy, disparities in healthcare are systemic and deeply rooted in historical inequality.

African Americans and Native Americans experience the highest poverty rates in America compared to other demographics, both exceeding 20% of those populations. The Latinx community has the highest uninsured rate of any racial or ethnic group in the country, hovering around 17% in 2017.

A lack of access to healthcare contributes to higher rates of illness and undiagnosed diseases. When it comes to closing the gap, affordable healthcare, preventative education and access to lab testing is at the heart of the issue. Other factors tied to poverty like food insecurity and housing conditions play a role in health and wellness as well. Healthcare is a national and intersectional issue that can only be solved when lines are drawn between inequality in multiple spaces, and disparities in vulnerable communities are tackled from every angle. This is why it’s important to know your candidate’s stance on issues related directly and indirectly to healthcare, and vote.

How is COVID-19 affecting healthcare on the ballot?

This election is happening in the midst of the COVID-19 pandemic and we have to consider how laws and policies regarding healthcare will affect issues related to the pandemic, and vice versa.

Aside from healthcare as a whole system, consider a candidate’s viewpoints on unemployment, mask mandates, social distancing guidelines, government-funded resources for individuals and small businesses, the climate crisis, etc. These issues contribute to the overarching effects of the pandemic and can give insight into how leaders will continue to tackle the pandemic moving forward.

Lastly, before you hit the polls, here are a few things you should remember to do before Election Day:

  • Register to vote! The deadline in most states is October 5 this year. You can find everything you need to know about registering, voting by mail, polling place locations and the link to your state’s official election website on If you’re not sure if you’re already registered, check your voter registration status on the NASS website.
  • If you’re planning on voting from home, request an absentee ballot before the deadline. Be mindful of the recent postal delays and give yourself enough time to mail off your ballot. In some states, you may also drop your ballot off at an official ballot drop box near you before the deadline.
  • Do your research about who and what is on the ballot, and make a plan to vote for the candidates and causes that most align with your values. Create a voter guide for yourself so you’re ready to tackle the polls on Election Day.
  • Bring your notes. While electronics are off-limits in the voting booth in most states, you are allowed to bring a piece of paper with notes into the booth with you. Printing or writing out your personal voter guide will ease the process on the day of the election.
  • If you plan on voting in person remember to wear a mask
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