Where the 2020 Democratic presidential candidates stand on health care issues

Topics: Finance, Costs and Prices, Health Care Reform, Industry, Prescription Drugs, Insurance, Medicare, Health Plans/Insurance Companies, Patient Populations, Women, Mental Health, Politics and Policy, Elections, Federal Government, Health Care Legislation, Public Health, Substance Use, Illicit Drugs, Prescription Drug Misuse

*Editor's note: This story was updated March 14, 2019 

Over the past few months, several candidates have announced they are seeking the Democratic nomination for president in 2020—and most have indicated health care will be one of their major priorities.

According to Ballotpedia, President Trump is the only Republican to have officially declared his presidential campaign so far. However, former Massachusetts Gov. Bill Weld (R) has said he would launch an exploratory committee to run for president as a Republican. Weld in his announcement said little about health care but noted, "The two most important tasks are to cut spending and cut taxes."

American Health Line will update this document throughout the 2020 presidential primary season to show where the prominent Democratic presidential hopefuls stand on health care.

Sen. Cory Booker (D-N.J.)

Sen. Cory Booker (D-N.J.) on Feb. 1 announced he is running for the Democratic presidential nomination—and health care is expected to play a role in his campaign.

Booker in the past has taken a number of actions that shed light on where he stands on various health care issues.

  • Health care reform: Booker in September 2018 voiced his support for Sen. Bernie Sander's (I-Vt.) so-called "Medicare-for-All" proposal, which would largely eliminate private health insurance and, over a four-year period, would expand Medicare to cover all U.S. residents Booker co-sponsored Sanders' 2017 Medicare-for-All legislation.
  • Marijuana legalization: Booker in February introduced a bill that would remove the federal ban on marijuana. Booker said the bill, called the Marijuana Justice Act, "seeks to reverse decades of ... unfair, unjust, and failed policy by removing marijuana from the list of controlled substances and making it legal at the federal level."
  • Prescription drug prices: Booker, who has agreed to no longer accept campaign donations from pharmaceutical companies, has co-sponsored legislation aimed at lowering prescription drug prices by allowing prescription drug imports from Canada into the United States.

Pete Buttigieg, mayor of South Bend, Indiana

South Bend, Indiana, Mayor Pete Buttigieg announced his campaign in January. Buttigieg has not talked in great detail about his health care priorities but he has spoken in depth about one policy issue.

  • Health care reform: Buttigieg has said while he feels a transition toward a Medicare-for-All program is "the right place for us to head as a country," he doesn't think such a proposal has to eliminate private health plans. During an interview with ABC's George Stephanopoulos, Buttigieg said, "If the framework we're using is Medicare, a lot of people who have Medicare also have Medicare supplements, Medicare Advantage, something like that." He continued, "So if we want to make Medicare available to everybody, whether it's as a public option to buy in or simply establishing that as how the payer structure works in this country, that's going to be the center of gravity." Buttigieg said, "The bottom line is, we need to make sure that every American is able to get health care."

Former HUD Secretary Julian Castro

Julian Castro, who served as secretary of the Department of Housing and Urban Development under former President Barack Obama's administration, in Jaunary announced he is running for the Democratic presidential nomination. Since the announcement, Castro has indicated his stance on a number of health care issues, including support for a universal health care system and efforts to lower prescription drug prices.

  • Abortion rights: Castro has said he supports legal access to abortion care, and has opposed a Texas law that bans abortions after 20 weeks of pregnancy and limits abortion access.
  • Health care reform: Castro during a recent event with Iowa Democrats said, "What you're going to hear from me is that … I support universal health care." Castro has expressed his support for Sanders' Medicare-for-All proposal, which largely would eliminate private health insurance and, over a four-year period, would expand Medicare to cover all U.S. residents. He said, "Medicare should be there for everybody in this country. It's time for Medicare for all, universal health care for every single American." Castro has said he would consider funding Medicare's expansion by raising taxes on U.S. corporations and the wealthiest "0.05, 0.5, or 1%" of U.S. residents.
  • Prescription drug prices: Castro also has criticized the effect drugmakers have had on health care costs and called for efforts to lower prescription drug prices. Though so far he has not indicated how he would seek to lower prices.

Former Rep. John Delaney (D-Md.)

Former Rep. John Delaney (D-Md.) announced his bid for the Democratic presidential nomination in July 2017, and has discussed his proposal for implementing a universal health care system in the United States.

  • Health care reform: Delaney has said he does not support Sander's Medicare-for-All proposal, calling it a "plan that will be very bad for [health care] quality and cost, and then ultimately be bad for access." Instead, Delaney has proposed a new public health plan that would cover all U.S. residents under age 65, including those currently enrolled in Medicaid. The plan would cover basic medical services comparable to those covered under the Affordable Care Act's essential health benefits. Employers would be allowed to offer and U.S. residents would be allowed to purchase supplemental health insurance that would cover additional services. Delaney said the cost of the new health plan would be covered by a shared federal-and-state payment system and by terminating tax breaks for employer health benefits.

Rep. Tulsi Gabbard

Rep. Tulsi Gabbard (D-Hawaii) in January also announced her candidacy for president, and has said bolstering U.S. residents' access to health care is one of her main priorities.

  • Abortion rights: Gabbard has expressed support for abortion rights and has voted against legislation to ban abortion after 20 weeks of pregnancy.
  • Health care reform: Gabbard co-sponsored legislation in the House that would expand health coverage to all U.S. residents. The expansion would be funded by increasing taxes on the 5% of U.S. residents with the highest incomes, establishing a progressive excise payroll and self-employment tax, creating a tax on income that does not come from employers, and taxing stock and bond transactions.

Sen. Kirsten Gillibrand

Sen. Kirsten Gillibrand (D-N.Y.) in January announced she also is running for president. Gillibrand has said her campaign will focus on advocating "for better health care."

  • Abortion rights: Gillibrand has indicated her support for expanding access to abortion and has opposed legislation to ban abortions after 20 weeks of pregnancy. Gillibrand also voted against confirming Supreme Court Justice Brett Kavanaugh because she claimed he could help overturn Roe V. Wade, which guaranteed U.S. women's right to abortion care.
  • Health care reform: Gillibrand co-sponsored Sanders' Medicare-for-All proposal. Gillibrand also has proposed expanding the Affordable Care Act's Basic Health Program to allow states to offer more U.S. residents lower-cost health coverage options.
  • Marijuana legalization: Gillibrand has said she supports full legalization of marijuana, and is co-sponsoring Booker's Marijuana Justice Act.
  • Maternal mortality: Gillibrand has introduced legislation aimed at reducing the U.S. maternal mortality rate. The legislation would give U.S. hospitals access to additional funds to implement best practices for maternal care.
  • Universal paid family leave: Gillibrand in 2013 introduced a bill designed to create a universal family leave program to pay U.S. workers when they need to take time off from work because they get sick, give birth, or have to care for their sick children, a parent, or a spouse.

Former Colorado Gov. John Hickenlooper (D)

Former Colorado Gov. John Hickenlooper (D)—who gained national attention in 2017 for releasing a bipartisan health reform proposal—in March announced his bid for the 2020 Democratic presidential nomination. Hickenlooper in the past has taken a number of actions that shed light on where he stands on various health care issues.

  • Abortion rights and reproductive health: Hickenlooper supports abortion rights, but it hasn't been a central issue for the former governor. Hickenlooper has touted his work to prevent unintended pregnancies in Colorado, particularly among teens in the state. Hickenlooper in 2014 praised a state initiative that provided more than 30,000 contraceptive devices at no- or low-cost to Colorado residents, which preceded a 40% reduction in teen pregnancy rates over five years. Hickenlooper also has expressed support for Planned Parenthood.
  • Health care reform: While serving as Colorado's governor, Hickenlooper worked to fully implement the Affordable Care Act (ACA) in the state by helping to create Colorado's state-run insurance exchange and expanding the state's Medicaid program. Hickenlooper and former Ohio Gov. John Kasich (R) in 2017 entered the health reform debate that raged in the House and Senate by offering a bipartisan health reform proposal that called for leaving the ACA's individual mandate and cost-sharing reduction payments to insurers in place, among other things. Recently, Hickenlooper said he supports transitioning the United States to a universal health care system, though he stopped short of embracing a specific Medicare-for-All proposal. Hickenlooper has said it is more important for policymakers right now to support implementing some form of universal health care, rather than promoting one specific proposal.
  • Marijuana legalization: Hickenlooper gained national attention for implementing legalized recreational marijuana sales in Colorado, after a majority of state voters in 2012 supported a state ballot initiative to legalize recreational marijuana sales in the state. However, Hickenlooper at the time said he, personally, was against legalizing marijuana. Hickenlooper since has said he believes the system he implemented in Colorado to legalize and regulate recreational marijuana sales worked.

Washington Gov. Jay Inslee (D)

Washington Gov. Jay Inslee (D) in March announced he is seeking the Democratic presidential nomination with a campaign focused on climate change, which he said "touches the heart of things so many of us care about: our jobs, our health, our safety and our children's future."

As Washington's governor, Inslee has advocated for policies to address a number of issues related to health care, including increasing access to mental health care, protecting abortion rights, reducing carbon emissions, and implementing a state-funded public health insurance option, among other things.

  • Abortion rights: Inslee's administration has taken action against Trump administration policies that Inslee has argued could restrict access to abortion care. For example, Inslee's administration in 2017 sued the Trump administration over interim final rules that significantly expanded exemptions available to employers that oppose the Affordable Care Act's (ACA) contraceptive coverage rules. Inslee also recently criticized the Trump administration's decision to finalize a rule that bars abortion providers and clinics that refer patients for abortion care from receiving Title X family planning grants, saying the rule places "tens of thousands of Washingtonians and millions of Americans" in danger. Inslee's administration has filed a lawsuit seeking to block the regulation.
  • Climate change as a health issue: Inslee's campaign will focus on tying climate change to other issues, including health care. Inslee in January told Fox News, "Climate change is a health care issue."
  • Health care reform: Inslee in 2013 signed a state budget that expanded Medicaid in the state, and since then, has called on policymakers to fully implement the ACA, including the law's Medicaid expansion. Inslee this year announced that state Democratic lawmakers in Washington would be introducing legislation to create a state-funded public health insurance option, which residents would be able to select on Washington's health insurance exchange. Inslee in his state budget proposal requested $500,000 to create the plan. He said the state-based public insurance option would represent a "step toward universal health care."
  • Marijuana legalization: Inslee recently issued pardons to more than 3,500 Washington residents who had misdemeanor convictions for marijuana possession. Washington has decriminalized marijuana, allowing it to be sold for recreational use.
  • Mental health: Inslee in a state budget proposal has requested $155 million to increase mental health care support in schools by funding guidance counselors, psychologists, and school nurses in elementary and middle schools. According to the Seattle Times, Inslee also has "overseen a multitude of crises in the state's mental-health system, including the federal decertification of the state's largest psychiatric facility."

Sen. Kamala Harris

Sen. Kamala Harris (D-Calif.) in January announced her candidacy for president, and has voiced her support for universal health care, Planned Parenthood, and access to mental health care.

  • Abortion rights: Harris is one of Planned Parenthood's most vocal supporters, and she has voted against legislation to ban abortions after 20 weeks of pregnancy.
  • Gender reassignment surgery: Harris has indicated she does not support requiring states to cover the cost of gender reassignment surgery for transgender inmates. She once filed a court motion to block California from covering the procedure for a transgender inmate.
  • Health care reform: Harris in August 2018 also announced her support for Sanders' Medicare-for-All proposal, and has indicated she will incorporate the proposal into her campaign. Harris co-sponsored Sanders' 2017 Medicare-for-All legislation.
  • Marijuana legalization: Harris has said she supports full legalization of marijuana, and is co-sponsoring Booker's Marijuana Justice Act.
  • Maternal health care: Harris has introduced legislation intended to reduce the United States' maternal mortality rate, particularly among black women.
  • Mental health care: Harris has introduced legislation that seeks to increase U.S. residents' access to mental health care.

Sen. Amy Klobuchar (D-Minn.)

Sen. Amy Klobuchar (D-Minn.) in February announced she was joining the swath of Democrats seeking the party's nomination for president, and she indicated health care will be one of her major priorities. Klobuchar has spoken about proposals to implement a universal health care system in the United States, among other health care issues.

  • Abortion rights: Klobuchar has said she believes abortion is a decision that should remain between a woman and her physician. Klobuchar co-sponsored the Women’s Health Protection Act, which bars states from establishing restrictions on abortions.
  • Health care reform: Unlike many other Democrats currently running for president, Klobuchar has not indicated her support for Sanders' Medicare-for-All proposal. Klobuchar has said she supports taking a more gradual approach toward implementing universal health coverage in the United States, noting about 50% of U.S. residents have private health insurance.
  • Marijuana legalization: Klobuchar in February said she "support[s] the legalization of marijuana and believe[s] that states should have the right to determine the best approach to marijuana within their borders."
  • Prescription drug prices: Klobuchar and Sen. Chuck Grassley (R-Iowa) in January introduced a bill called the Safe and Affordable Drugs from Canada Act of 2019, which aims to address high prescription drug prices by allowing U.S. residents to import drugs from Canada. Klobuchar also has pushed for federal lawmakers to approve legislation that would allow CMS to negotiate prices for drugs covered under Medicare Part D. In addition, Klobuchar has introduced legislation that would allow the federal government to prevent drugmakers from entering so-called pay-for-delay agreements, under which brand-name drugmakers pay generic drugmakers to delay when generic versions of their products enter the market.

Former Rep. Beto O'Rourke (D-Texas)

Former Rep. Beto O'Rourke (D-Texas) in March announced that he is seeking the 2020 Democratic nomination for president, and indicted health care will be a priority in his campaign. O'Rourke served three terms in the House, representing Texas' 16th congressional district. Last year, he unsuccessfully sought to unseat Sen. Ted Cruz (R-Texas). O'Rourke's time in Congress and on the campaign trail has provided insight into his positions on various health care topics.

  • Abortion rights: O'Rourke has long supported abortion-rights. His campaign website during his unsuccessful 2018 Senate bid stated policymakers should "ensur[e] that a woman's right to choose is not compromised by limited access to safe and legal abortion services or family planning help."
  • Health care reform: O'Rourke during his time in Congress helped pass legislation related to temporary health benefits, and has urged Texas lawmakers to expand Medicaid under the ACA. However, O'Rourke has criticized the ACA for not going far enough to ensure all U.S. residents have access to affordable health coverage, and has said policymakers should create incentives to encourage health insurers to participate in the ACA's exchanges. In addition, O'Rourke has said he wants the United States to achieve universal health coverage, "whether it be through a single-payer system, a dual system, or otherwise." O'Rourke has expressed support for Sanders' Medicare-for-All legislation, but in 2017 said he opposed a House Medicare-for-All bill because he believed it would "fundamentally change Medicare, limiting the pool of potential providers, and therefore the choice available to Americans when seeking health care." O'Rourke also has said he supports implementing a public option health plan.
  • Marijuana legalization: O'Rourke has called for legalizing marijuana nationwide and expunging the records of individuals who have been jailed for possessing marijuana.
  • Prescription drug prices: O'Rourke during his 2018 Senate campaign called for allowing the federal government to negotiate prescription drug prices.

Sen. Bernie Sanders (I-Vt.)

Sanders in February announced he is seeking the Democratic nomination for president in 2020, and said his campaign will focus on various health-related initiatives.

Aides to Sanders said his presidential campaign will focus on a number of his health-related proposals, including promoting his Medicare-for-All proposal, lowering U.S. drug prices, legalizing marijuana, and ensuring workers have access to paid medical leave.

Sanders' recent proposals and past campaigns can offer insight into the proposals he might put forth during his campaign, as well as into where he stands on other major health care issues.

  • Abortion rights: Sanders during his 2016 presidential primary race against former Secretary of State Hilary Clinton, implied that he would not support any restrictions on abortion care.
  • Health care reform: Sanders in 2017 introduced legislation that would implement his Medicare-for-All proposal, which would largely eliminate private health insurance and, over a four-year period, would expand Medicare to cover all U.S. residents.
  • Marijuana legalization: Sanders has said he supports full legalization of marijuana, and is co-sponsoring Booker's Marijuana Justice Act.
  • Opioid epidemic: Sanders in 2018 introduced a bill that would impose penalties on drug manufacturers and pharmaceutical executives in cases of deceptive marketing or illegal distribution of prescription opioids. According to a summary of the bill, the measure would prohibit pharmaceutical companies and their employees from disseminating direct-to-consumer advertising that falsely suggests opioids have no addictive qualities or risks. Pharmaceutical companies that violate that policy would be fined 25% of the profits derived from their opioid products. In addition, executives would face criminal liability and could face fines equal to the executive's compensation package or a minimum of 10 years in prison.
  • Prescription drug prices: Sanders has proposed the federal government take aggressive action to address high U.S. drug prices. Sanders in January introduced a legislative package intended to lower prescription drug costs that includes three bills:
    • The Affordable and Safe Prescription Drug Importation Act (HR 2228), which would allow U.S. residents, pharmacists, and wholesalers to import lower-cost drugs from Canada and other developed countries;
    • The Medicare Prescription Drug Price Negotiation Act (S 41), which would allow the HHS Secretary to negotiate prices for drugs covered under Medicare Part D; and
    • The Prescription Drug Relief Act, which would set U.S. drug prices based on the median prices in Canada, France, Germany, Japan, and the United Kingdom, and require FDA to approve generic versions of the drugs—regardless of whether the drugs are protected by patents—if drugmakers refuse to lower prices to meet the new target

Sen. Elizabeth Warren

Sen. Elizabeth Warren (D-Mass.) in late December announced she had launched an exploratory committee to fill key staff positions for a campaign to run for president in 2020. Media reports have indicated Warren's bid for president would focus on health care issues such as prescription drug prices, health care reform, and the opioid epidemic.

  • Marijuana legalization: Warren has said she supports full legalization of marijuana, and is co-sponsoring Booker's Marijuana Justice Act.
  • Health care reform: In March 2018, Warren backed a bill intended to bolster consumer protections in the private health insurance market. Warren has said she supports Sander's Medicare-for-All proposal and co-sponsored Sanders' 2017 Medicare-for-All bill.

Marianne Williamson, an author and lecturer

  • Health care reform: Marianne Williamson in 2017 called Sanders' Medicare-for-All proposal "an idea whose time has come."

Andrew Yang, an author and entrepreneur

  • Health care reform: Andrew Yang has called for a transition to Medicare-for-All—though it's not clear whether he supports Sanders' proposal.