KFF Health News – The race to win the quickly approaching Iowa caucuses was the theme running through Wednesday night’s Republican presidential debate hosted by CNN at Drake University in Des Moines, Iowa. Front-runner Donald Trump was again absent and only two other candidates made the cut: Florida Gov. Ron DeSantis and former South Carolina Gov. Nikki Haley.
The two candidates touched on a variety of health care topics. As in previous debates, they each questioned the other’s anti-abortion bona fides and reaffirmed their own. They sparred over covid-19 policies as well as whether to push China out of the U.S. supply chain for pharmaceuticals and other health-related products.
Asked whether, as president, they would preserve the Affordable Care Act’s Medicaid expansion, both said — after being pressed for clarification — they would like to convert the program to a block grant. That’s generally understood to be an approach in which federal funding is capped but state flexibility is increased.
Forty states and the District of Columbia, but not South Carolina or Florida, have expanded Medicaid under the ACA, which is credited with providing insurance coverage to millions more Americans.
Block-granting Medicaid isn’t a new idea. The approach has long been favored by Republicans and was advanced by the Trump administration. It’s strongly opposed by Democrats.
In terms of health care policy, Haley again promised to add transparency to the U.S. system, emphasize competition, and put patients “in the driver’s seat.” She also promised tort reform.
DeSantis argued for “health care that’s accessible, that’s affordable, and that’s accountable, and particularly an emphasis on mental health.” He also pointed to his Florida experience. “We got accountability for the pharmacy benefit middlemen that are causing your drug prices to go up,” he said, and claimed another victory in the war on high drug costs.
The FDA last week approved Florida’s plan to import certain medicines from Canada for some state agencies. But the plan faces hurdles, including Canada’s government, which has warned it won’t allow U.S. imports if they risk causing drug shortages for Canadians.
Meanwhile, primary front-runner Trump again declined an invitation to debate. He instead participated in a Fox News town hall, also in Des Moines.
He claimed responsibility for the Supreme Court’s decision to overturn Roe v. Wade: “I did it. And I am proud to have done it,” he said.
But in response to a voter who sought assurances he would ban abortion nationwide if he won another presidential term, Trump acknowledged the politics of the issue. He told the voters “you still have to win elections” and that “a lot” of Republicans have been “decimated” as a result of advocating strict abortion bans.
He carefully avoided saying what kind of ban, precisely, he would propose if he made it back to the White House …