Democrats vs Republicans: What Is Their Stance On Healthcare?

Learn about the key differences between the Democratic and Republican stances on healthcare policy.
Congressional Democrats speak during a health care news conference on Capitol Hill, Wednesday, Jan. 4, 2017, in Washington.(AP Photo/Evan Vucci)

Congressional Democrats speak during a health care news conference on Capitol Hill, Wednesday, Jan. 4, 2017, in Washington.(AP Photo/Evan Vucci)

Where do Democrats and Republicans stand on the issue of healthcare?

The chasm between the parties’ approach to providing healthcare to Americans couldn’t be more vast. Simply put, Democrats have had some form of healthcare reform on their agenda for nearly a century. Republicans not so much. They feel that the status quo is just fine. At the core is a philosophical disagreement about the role of government. Democrats believe that government should be responsible for the people in some ways, and Republicans believe that the less government, the better. In the current climate, this boils down to Democrats wanting to retain, improve, and expand the ACA, and Republicans working overtime to repeal it with no replacement.

Democratic View On Healthcare

Democrats have always been in favor of governmental involvement in the wellbeing of Americans, especially the most vulnerable among us. Healthcare reform has been a primary focus for the party since the middle of the Twentieth Century. Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and the ACA are all major reforms the Democrats fought for and got passed into law. During this election season, healthcare is arguably the hottest topic of debate, and Democrats are pushing for further expansion across the board. The key phrase to remember is “quality, affordable health care for all Americans.”

Republican View On Healthcare

Republicans take pretty much the opposite view of Democrats. Traditionally dedicated to the notion that less government is better government, and the free market makes adjustments on its own without regulation, the party has fought every reform the Democrats have enacted. Much of this comes down to their traditional diametrically opposed notions of what is best for Americans. Citing freedom of choice and the sacrosanct doctor-patient relationship, predicting huge losses to the economy in general, arguing that the ACA “doesn’t work” despite years of evidence to the contrary, the GOP would rather scrap it and go with the status quo as it stood before the ACA was passed. Their key phrase is “Why should healthy people pay more to cover sick and poor people?”

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Democrats vs Republicans: Healthcare Policies

To get a clear sense of the radical difference between how the two parties approach healthcare, let’s take a more granular look at where they stand on the policies and proposals currently in play.

Affordable Care Act


The ACA is the Democrats’ baby. They not only want to keep it, they want to expand on it and improve it. They realize that it’s just the beginning, recognize it has flaws, and see it as an excellent base on which to improve and build.


For Republicans, the ACA is the worst thing to come down the pike in ages. They fought long and hard first to stop it from becoming law, and second to repeal it altogether. The Trump Administration is currently trying to validate the law via court ruling. They see it as socialized medicine, a violation of patients’ rights, bad for the healthcare industry across the board, and bad for the country. They are particularly vexed at the subsidies and expanded Medicaid access, and worked to eliminate the Individual Mandate.

Medicaid Expansion


Medicaid expansion is a centerpiece of the ACA. It gives states the option to broaden access to Medicaid benefits by loosening eligibility requirements. States that adopt it can provide care to those who normally fall between cracks. Democrats would like to see it become more widespread.


Republicans oppose Medicaid expansion, and have worked to vastly reduce the number of people eligible. Most GOP lawmakers would love to get rid of Medicaid altogether. Most Red states have refused to expand Medicaid access. Ultimately, the GOP sees it as socialized medicine and a glide path to universal single-payer healthcare. Which is anathema to them.

Medicare for All


Only the most progressive wing of the Democratic party supports Medicare for All. Most feel that it’s not fiscally feasible, would be deleterious because of its impact on the healthcare industry, and would take away choice for Americans.


Republicans abhor the notion of Medicare for All. They see it as a handout that people don’t deserve, a potential fiscal disaster, a pipe dream, and the fast track to turning the US into a socialist, or even Communist state. It’s a big “no” for them.

Public Option


Most Democrats acknowledge that the ACA is a work in progress, and they support the idea of a public option being added to it. What kind of public option varies, but at the moment there are several proposals being considered in Congress.


As with all elements of Democrats’ push for healthcare reform, the Republicans are united against a public option. They would rather see all governmental involvement in healthcare disappear for good. The GOP response to any public option would be “hard pass.”

Private insurance/Employer-based healthcare


Progressives in the party want to replace private insurance and employer-based healthcare altogether. But the majority of Democrats see the current situation as something that, although broken, can and should be fixed. They understand the costs associated with wiping out an entire industry representing 1/5 of the US GDP and their goal is to redress the problems, not burn it down and start from scratch.


This is the only form of healthcare Republicans support. And they don’t see any need to change it. In fact, the further government stays from involving itself in healthcare the better.

Women’s Reproductive Rights


In these times of GOP attacks on women’s reproductive rights, the consensus among current candidates is to codify Roe v Wade, to repeal the Hyde Amendment (which makes it illegal to use federal funds for abortions except in the case of rape, incest, or potential harm to the mother), to support Planned Parenthood, and to prioritize women’s reproductive rights in whatever healthcare reforms are passsed going forward.


The GOP is dedicated to limiting women’s reproductive rights, in some cases quite egregiously. They are anti-abortion, anti-Planned Parenthood, anti-choice, and most decidedly anti-Roe v Wade. A good example of what Republicans would like to see happen is the law Georgia passed in 2019 banning abortion at the point a doctor can detect a fetal heartbeat—even before 6 weeks. A federal judge temporarily blocked the law. But these kinds of battles are common, and illustrate how passionately the GOP wants to legislate what women do with their bodies.

Obama And Trump Healthcare Policies, Compared

There could not be a more radical divide between administrations than there is between these two. The Obama administration worked against almost insurmountable opposition from the GOP in order to pass the ACA. The Trump Administration’s quest is to dismantle everything the Obama Administration has done. They even have court cases pending in order to do so.

Obama Administration:

President Obama began his first four years with the goal of widespread healthcare reform. He wanted to make it affordable, efficient, and accessible, and he wanted to make sure that the 50 million people who were dropping through the cracks at the time had a way to cover health costs. He had learned from watching the Clinton Administration try and fail, and took the approach of leaving the nitty-gritty of drafting the proposal to Congress. This was remarkable in itself, in part because it was predicated on the belief that Democrats and Republicans could find a viable way through the process and come out with a product that would benefit the lives of ordinary Americans.

And he was right. The ACA certainly wasn’t and isn’t perfect, but the Obama Administration gave the country a good start in correcting what is wrong with healthcare. Millions now enjoy coverage that didn’t before. There are premium subsidies for those who meet the economic requirements, expanded Medicaid in the states that have taken advantage of the program, and people with pre-existing conditions are not penalized by refusal to cover or unreasonable premiums.

Trump Administration:

For the first two years of the Trump Administration, the GOP had control of both the House and the Senate. They had been railing against the ACA and threatening to repeal it from the moment it passed. Their very first order of business was to “Replace and Repeal” the law. They worked diligently to garner support for repeal and developed their own alternative healthcare plan behind closed doors, ultimately forcing the vote even though their colleagues had almost no time to review it. In broad strokes, their plan offered bare-bones coverage, tax credits, and health savings accounts instead of federal subsidies, a cap on individual tax deductions for healthcare costs, a ban on coverage for pre-existing conditions, and giving states grants for Medicaid rather than administering the program at the federal level.

This attempt ultimately failed, due to a huge public outcry and the Democrats taking back control of the house in 2018. The Trump Administration has not, however, given up. They subsequently resorted to lawsuits to challenge various elements of the ACA and their DOJ is currently in court seeking to invalidate the law entirely. That story isn’t over yet.

The Rantt Rundown

The notion that the Democratic and Republican parties are pretty much the same, and a vote for one is no different than a vote for the other, has been floating around our culture for quite some time. A brief comparison of the Republican and Democratic parties’ approaches to healthcare demonstrates how untrue that is. The Democratic party’s mandate is to make healthcare affordable and as universally accessible as possible, with Medicare, Medicaid, and the Affordable Care Act as proof of their commitment. The Republican party has actually done all it could to undermine, even eliminate these reforms, preferring the free-market, consumer-based system already in place, which leaves millions and millions of Americans uncovered. Which approach do you prefer?

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