No talk of Obamacare. Or abortion.
At the Republican National Convention in Milwaukee this week, where delegates formally nominated Donald Trump as the party’s 2024 presidential candidate, health care received little attention from prime-time speakers.
The silence is surprising, given that health care makes up the largest share of the federal budget, nearly $2 trillion, and accounts for 17% of U.S. economic output.
It also stands in stark contrast to the priorities of the Republican Party when it first nominated Trump.
In 2016, the last time Republicans gathered en masse for a presidential convention, repealing the Affordable Care Act was a favorite topic. As was repealing Roe v. Wade and its constitutional protections for abortion.
The change in tone reflects Trump’s political sensitivities. The former president’s failed 2017 repeal of Obamacare helped to hand the GOP a landslide defeat in the 2018 congressional elections, and the bill now enjoys broad support. Abortion has also become a tricky issue for Republicans since Roe was overturned in 2022, with a majority of Americans opposing a nationwide ban.
In one of the few pieces of the Republican Party’s 2024 health policy platform, the former president promises he will not cut Social Security or Medicare, the health care program for older and disabled Americans, or change the federal retirement age.
In his nomination acceptance speech Thursday night, Trump promised to protect Medicare and find cures for Alzheimer’s and cancer. But he offered no health care proposals for a second term. “The Democrats are going to destroy Social Security and Medicare,” he said.
Health care is not an issue that Republicans will like, said Charles Coughlin, CEO of a Phoenix public affairs firm who was a longtime GOP political activist before becoming an independent in 2017.
Instead, convention speakers focused on inflation, crime and immigration. “They have tried-and-true polling data that shows those are winning issues for them, and that’s where they want to focus the narrative,” he said.
Immigration has affected several health issues, including the U.S. opioid crisis and public insurance. Some Republicans — including Georgia Rep. Marjorie Taylor Greene, who spoke at the convention July 15 — have argued that the augment in people crossing the southern border has led to an augment in drug overdoses and deaths.
However, according to the Cato Institute, a libertarian think tank, most fentanyl seized at the Mexican border enters the U.S. through legal border crossings, and according to the U.S. Sentencing Commission, most people convicted of fentanyl trafficking in the U.S. are American citizens.
Speaking on July 17, U.S. Rep. Monica De La Cruz of Texas said the Democratic policy allows people who enter the country without authorization to receive government benefits even though they are largely ineligible for federal health programs.
De La Cruz also said the Biden administration has cut Medicare Advantage for seniors. While the Biden administration has modestly cut spending on private plans this year, the federal government still spends more money per beneficiary on Medicare Advantage than it does on people in the established Medicare program.
The dearth of health care-focused convention speakers reflects the recent GOP platform, a document that closely follows Trump’s views in both substance and tone. In addition to promising to protect Medicare, the 28-page document promises that Republicans will expand health care choices for veterans, as well as access to “new affordable health care and prescription drug options” more broadly, without elaborating.
On abortion, the party has removed its decades-long call for federal restrictions from its platform, including instead language suggesting that the 14th Amendment prohibits abortion. The platform also says the party supports state-level choices on abortion policy and opposes “late-term abortion.” Only about 1% of abortions in the U.S. occur after 21 weeks of pregnancy, according to KFF, a nonprofit health information organization that includes KFF Health News.
The 2016 platform, a 66-page document, also called for shifting open-ended federal Medicaid funding to block grants and introducing a Medicare “premium support model” to curb spending. It also called for capping malpractice lawsuit payouts and cracking down on drug abuse.
The word “abortion” appears 32 times in the 2016 program, while in the 2024 document it appears once.
“The Republican Party is running away from this issue like a storm,” Coughlin said.
During the week of the convention, a recording of a phone call between independent presidential candidate Robert F. Kennedy Jr. and Trump surfaced online. On the recording, Trump can be heard sharing debunked claims about childhood vaccines, falsely claiming that vaccines can cause a “radical change” in a child and downplaying their health benefits.
As a candidate, Kennedy repeatedly made false claims about the safety and effectiveness of vaccines. Trump has long entertained vaccine skeptics. (Before Trump took the oath of office in 2017, Kennedy told reporters that Trump had invited him to chair the president’s commission on vaccines, though the commission never materialized.) But as president, Trump ordered the creation of “Operation Warp Speed” in 2020, which helped develop COVID-19 vaccines.
But since the start of the pandemic, vaccine skepticism has blossomed within the Republican Party. Only 36% of Republicans say they believe COVID vaccines are secure, while 44% of Republicans and Republican-leaning independents believe parents should be able to choose not to vaccinate their children against measles, mumps and rubella, “even if doing so may pose a health risk to other children and adults,” according to a KFF poll.
