Vice President Kamala Harris' selection of Minnesota Gov. Tim Walz as her running mate is making health care a front-burner issue in the final sprint to the November presidential election.
Walz, a 60-year-old former high school teacher and football coach, has a record of supporting left-leaning health care initiatives during his two terms as governor and while serving in the U.S. House of Representatives from 2007 to 2019. He also leads a state central to the health care industry: Minnesota is home both to the nation's largest health insurer, UnitedHealth Group, and one of its most prestigious hospital systems, the Mayo Clinic.
Republicans have seized on his record to portray the Harris-Walz ticket as extreme on health care, while Democrats say Walz's efforts to lower drug costs and preserve abortion access are mainstream positions that appeal to swing voters. Either way, his selection thrusts health care center stage as an election issue, underscoring the primacy of the nation's battle over abortion access as well as voters' deep angst over spiraling health care costs.
Many of Walz's stances dovetail with those of Harris.
He has fought for abortion access, signing legislation to codify abortion rights in the state, and in March toured a Planned Parenthood clinic with the vice president.
He supported congressional legislation empowering the federal government to negotiate drug prices in Medicare, a health insurance program for seniors and the disabled. The Biden administration on Aug. 15 released new, reduced prices for 10 drugs in the program that stem from the negotiations between the government and drugmakers. The lower costs will kick in in 2026.
As governor, Walz signed legislation in 2020 to cap out-of-pocket insulin costs to $35 a month for eligible residents with an urgent need for the medication. Two years later, President Joe Biden did the same for all Medicare patients.
Early in the covid-19 pandemic, Walz mandated that masks be worn in most indoor public spaces. He extended an executive stay-at-home order in 2020, which led former President Donald Trump to post "LIBERATE MINNESOTA!" on X, the social platform then called Twitter.
"He has common sense when it comes to issues and policy," said Andy Slavitt, a former UnitedHealth executive and former administrator of the Centers for Medicare & Medicaid Services. "He's not an ideologue. He's an independent thinker who cares about people who don't have resources," said Slavitt, who served as a senior adviser to the Biden administration's covid response team.
Walz also has championed fertility treatments, sharing his personal story of how he and his wife, Gwen, relied on them to conceive. Because in vitro fertilization is under increasing threat by some abortion opponents, despite its broad popularity, his firsthand knowledge of fertility challenges is adding political muscle.
"Walz has been articulate and passionate about his experience with IVF, and that connects with people on both sides of the aisle," said Christoper Sheeron, founder and president of Action for Health, a national nonprofit advocacy organization.
Republicans in Minnesota say Walz's health care positions will work against the Democratic ticket. They criticize his 2021 covid vaccination or regular testing requirement for state employees, his support of legislation codifying abortion rights, his backing of recreational marijuana legalization, and a bill he signed to expand public health coverage to some immigrants lacking legal residency.
"Under Gov. Walz, we saw one of the most radical, far-left agendas in the country. While Americans are searching for unity, Walz has a record of implementing extreme policies that only divide us further," the Republican leader of Minnesota's state Senate, Mark Johnson, said in a statement. "He has put our state on a path to government-run health care and championed restrictive health care mandates that limit Minnesotans' access to life-saving care."
Minnesotan Tracy Mitchell said that before Walz's selection she was leaning toward backing former President Donald Trump in November because she believed he would do more to lower her health care costs.
The announcement cemented her decision: She's voting for Trump.
"I have three kids, and health care gets expensive," Mitchell, 38, of Ham Lake, said while visiting Stillwater, Minnesota, with her family. She is the director of program operations for a mental health care clinic.
"The way he handled covid, and in terms of health care, I think he is too extreme," she said.
Still, Democrats express hope that a greater focus on health care will give them an advantage in the election, tapping into voter concerns about pocketbook issues in swing states.
Forty-eight percent of Republicans or adults who lean Republican said health care affordability is a very big problem in the country, according to a May poll by the Pew Research Center. Sixty-five percent of Democrats or adults who lean Democratic agreed.
The concern tops illegal immigration, the federal budget deficit, gun violence, and drug addiction.
Three in 4 adults said they are very or somewhat worried about being able to afford unexpected medical bills, based on a poll done in January and February by KFF, a health information nonprofit that includes KFF Health News.
"Republicans have always suffered because they talk about health care in economic terms," said William Pierce, who is a senior director at APCO Worldwide, a global advisory and advocacy firm, and a former GOP congressional aide. "Democrats talk about it as a personal issue. The selection of Walz gives them a greater opportunity to push it harder."
Walz's counterpart on the GOP ticket, Ohio Sen. JD Vance, has less experience with health care issues. But he has sought to show concern about rising costs and barriers to care.
During a recent visit in Eau Claire, Wisconsin, Vance said the government must do more to preserve health care access in rural America.
In a July 2017 op-ed published by The New York Times, well before he ran for the Senate as a Republican, Vance expressed support for some provisions of the Affordable Care Act and criticized the GOP push to repeal the law because, he said, the proposal "withdraws its supports for the poor."
Since joining Trump's ticket, Vance has aligned his views with Trump's on the ACA — a law Trump tried and failed to repeal while president.
"The difference is between those defending the ACA and those who would repeal it; the choice of Walz makes that contrast as clear as ever," said Anthony Wright, the executive director of Families USA, a nonpartisan organization focused on health care access and affordability.
Vance has backed letting the federal government negotiate Medicare drug prices — a rare point of agreement on health policy with Democrats.
Like Trump, he opposes gender-affirming care for transgender minors. But he has taken firmer positions than the former president on abortion — a vulnerability Democrats have sought to exploit. Public support of abortion rights has increased since the Supreme Court struck down Roe v. Wade in 2022 and many Republican-led states moved to impose strict bans.
Both the Democratic and Republican campaigns are drawing fresh scrutiny of their positions on health care. California Lt. Gov. Eleni Kounalakis' super PAC, Californians for Choice, released an ad this month saying Vance supports a nationwide abortion ban, "stripping away our freedom."
Like Trump, Vance has recently said states should decide specific abortion policies, but he previously supported outlawing abortion nationwide.
Trump's campaign, meanwhile, has labeled Walz "Tampon Tim" because of a state law he signed requiring menstrual products to be available to “all menstruating students in restrooms regularly used by students in grades 4 to 12, according to a plan developed by the school district."
A recent Trump campaign ad called Walz "too weird. Too radical."
But Walz's addition to the ticket has energized Democratic voters with health care concerns such as Angel Palm, 32, a life coach for people with disabilities who lives in Fridley, Minnesota.
"My son is autistic and has medical costs. It's so important," she told KFF Health News. "I'm so stoked."
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 This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF - the independent source for health policy research, polling, and journalism.
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