[CLIP: Theme music]
Rachel Feltman: For Science Rapidly, that is Rachel Feltman. The 2024 election is approaching quick, and we’re right here that will help you prep in your journey to the polls. Over the previous couple of months, Scientific American’s editors have been reporting on how Donald Trump and Kamala Harris strategy the science-related coverage points that impression our on a regular basis lives. They’ve been speaking to consultants on matters like gun violence, well being care, immigration and extra to assist clarify what a Trump or Harris presidency would possibly imply for these points within the years to return.
At this time we’re going to be listening to from a couple of of these Scientific American editors about what they’ve discovered. First up is Tanya Lewis, a senior editor who covers well being and drugs, to offer us a primer on how the 2024 election may impression reproductive rights.
On supporting science journalism
In the event you’re having fun with this text, contemplate supporting our award-winning journalism by subscribing. By buying a subscription you might be serving to to make sure the way forward for impactful tales concerning the discoveries and concepts shaping our world right now.
Tanya Lewis: Trump and Harris have fairly starkly completely different views and data on this subject.
Trump has had a fairly large impression on abortion entry. He’s appointed three Supreme Courtroom justices that helped overturn Roe v. Wade, and that led to abortion bans or [substantial] restrictions in about half of all U.S. states.
[CLIP: Donald Trump speaks at September’s presidential debate: “We’ve gotten what everybody wanted: Democrats, Republicans and everybody else, and every legal scholar, wanted it to be brought back into the states.”]
[CLIP: “Let There Be Rain,” by Silver Maple]
Lewis: So Trump says that he needs to return abortion choices to the states, and he has additionally mentioned that he would veto a nationwide ban if one had been handed by Congress. However he’s additionally mentioned, quote, “We’ll see [what happens].” And that’s not the one approach {that a} nationwide ban may occur; Trump may additionally simply attempt to implement the Comstock Act, which is a Nineteenth-century obscenity legislation that [nominally] bans mailing of supplies which can be used for abortion. Trump’s VP decide, J. D. Vance, has beforehand said publicly that he would help implementing a nationwide ban just like the Comstock Act, however he’s since claimed that Trump needs the problem to be determined by states.
Mission 2025 is the conservative agenda that Trump has distanced himself from however which was truly written by lots of his former colleagues. And that mission principally helps the usage of the Comstock Act to roll again abortion rights. It additionally requires reporting information on particular person pregnancies and abortions to the U.S. authorities.
Abortion bans truly have an effect on issues like routine being pregnant care or emergency care. There are already girls who’re dying due to miscarriages or ectopic pregnancies. Docs [in some states] are scared of truly performing in these circumstances as a result of they’re afraid that they’re gonna face prison expenses.
Trump has falsely claimed that Harris helps abortion “after delivery,” however that’s truly a meaningless time period as a result of abortion isn’t a authorized factor that may occur after delivery anyplace on this nation.
[CLIP: “The Farmhouse,” by Silver Maple]
Harris’s marketing campaign has been far more centered on supporting reproductive rights, together with abortion. The Biden-Harris administration truly signed a number of government orders that shield abortion and abortion treatment. The Biden-Harris administration has defended abortion entry in a few completely different Supreme Courtroom circumstances. One in all them concerned the approval of mifepristone, the abortion treatment, by the [Food and Drug Administration], and one other one concerned emergency abortion care in Idaho.
The Biden-Harris administration expanded protection of abortion-related journey and entry to contraception below Medicaid, the federal government insurance coverage program for low-income people. Harris has vowed to signal laws that might shield abortion if she’s elected. Now, after all, that is depending on whether or not or not Congress passes such laws, which is considerably unlikely on this setting.
[CLIP: Kamala Harris speaks at September’s presidential debate: “And I pledge to you, when Congress passes a bill to put back in place the protections of Roe v. Wade, as president of the United States, I will proudly sign it into law.”]
Lewis: To be able to get across the roadblock of Congress, Harris has known as for eliminating the filibuster to assist Democrats shield abortion entry.
So coming again to Mission 2025, that plan would strip away entry to contraception by eliminating the Inexpensive Care Act’s contraception mandate. Trump additionally weakened the Title X family-planning community, which supplies low-cost contraception and reproductive well being care. He did this by disqualifying clinics that present abortions or abortion referrals.
The Biden-Harris administration supported contraception protection below Medicaid, together with from Deliberate Parenthood, which supplies many reproductive well being companies along with abortion care.
With all this dialogue of abortion and reproductive well being, we also needs to discuss IVF; that’s in vitro fertilization. As soon as Roe was overturned the Alabama Supreme Courtroom dominated that embryos [created through IVF] are thought of youngsters, so [several] IVF clinics paused or stopped therapy. Trump has mentioned that he needs to make IVF free, however he doesn’t actually have the facility to do this with out Congress. And it might be fairly unrealistic as a result of Democrats in Congress truly launched a invoice to guard IVF, however Republicans blocked that invoice each instances.
Each Harris and her VP decide, Tim Walz, have mentioned that they strongly help IVF. Walz himself mentioned that his household used fertility therapy, though not IVF particularly, to conceive his youngsters.
[CLIP: “Krebeasy (Instrumental),” by Kreb]
So simply to summarize: if elected, Donald Trump would probably proceed to roll again reproductive rights, whereas Kamala Harris would probably shield them. The president has numerous energy to direct the Justice Division to implement legal guidelines and to appoint Supreme Courtroom justices, however the president can solely accomplish that a lot. I imply, the courts and state legislatures are additionally essential on this course of, and there are literally 10 state-level poll initiatives on abortion this 12 months. So this election may have repercussions for years to return.
Feltman: Since Tanya recorded that explainer for us, the Biden-Harris administration has come out swinging with a proposal to increase protection of over-the-counter contraception. If finalized, the proposed rule would enable folks to entry emergency contraception with out prescriptions and for no further value. They’d even have free entry to Opill, the each day oral contraceptive authorised for over-the-counter gross sales in 2023.
That brings us to our subsequent election concern, which is that well being care within the U.S. is dear—like, severely. The U.S. famously pays greater than different developed nations in terms of prescribed drugs and different drugs. Each Trump and Harris declare to have options. Right here’s Lauren Younger, an affiliate editor for well being and drugs at Scientific American, to stroll us by means of their stances on reasonably priced well being care.
Lauren Younger: The U.S. is dealing with many points with reasonably priced, accessible well being care, and each presidential candidates say their agendas will enhance it.
[CLIP: “Those Rainy Days,” by Elm Lake]
Drug pricing has been a extremely large a part of Harris’s marketing campaign. She was very instrumental within the passing of the Inflation Discount Act in 2022; she forged the tie-breaking vote in Congress. The Inflation Discount Act can be known as the IRA. This new laws places limits on drug worth will increase below Medicare; that’s the federal insurance coverage program for adults age 65 and older.
So the IRA does quite a few issues. Essentially the most talked about in Harris’s marketing campaign is that this $35 month-to-month cap on insulin, which is an important lifesaving drug for these with diabetes. It additionally made Medicare-covered vaccines free. Each of these issues went into impact in 2023.
There are a pair issues that may go into impact a little bit later. The IRA will put a $2,000 out-of-pocket annual spending cap on prescribed drugs below Medicare beginning in 2025. So to offer a greater understanding of what this can seem like, most cancers sufferers, as an example, who want these medicine, these drugs can value anyplace from $10,000 to $15,000 a 12 months, however the IRA will drop that cap to $2,000.
The IRA additionally grants Medicare the power to barter decrease costs for sure drugs. Ten medicine have already been chosen for this, however folks received’t begin seeing these worth adjustments on the pharmacy till January of 2026.
So Harris has mentioned she plans on increasing the IRA as president. She would decrease prices for much more medicine for these below Medicare. She’s additionally hoping to increase this out to different medicine that might be coated by personal insurance coverage and Medicaid.
However since these negotiations don’t go into impact till 2026, a Trump administration may theoretically attempt to block or undo this. They’d have to maneuver tremendous quick, however it’s not totally not possible. My consultants say that some Republican Get together members fear that the brand new drug worth negotiations would possibly trigger corporations to lose incentive to innovate or produce new medicine, and most of the corporations that produce these 10 medicine which were chosen have sued the federal government to cease these negotiations.
Trump tried to deal with prescription drug prices throughout his administration. In his closing months in workplace he tried to implement a pair government orders. One in all them was the “Most Favored Nation” pricing mannequin, which might set sure clinician-prescribed medicine below Medicare at decrease common prices which can be nearer to the value in different developed nations. The Biden administration pulled the plug on this order again in 2022. Trump initially supported bringing again the Most Favored Nation mannequin if he had been reelected, however he has just lately walked again these statements.
One other large well being care concern is entry to reasonably priced care. Trump has made plenty of false claims and exaggerations about his historical past with the Inexpensive Care Act—most famously was in the course of the September debate with Harris, the place he mentioned he, quote, unquote, “saved” the ACA.
[CLIP: Donald Trump speaks at September’s presidential debate: “I had a choice to make: Do I save it and make it as good as it can be, or do I let it rot? And I saved it. I did the right thing.”]
Younger: Throughout his administration he repeatedly tried to repeal the ACA. He failed to take action, however he made a number of legislative and budgetary choices that weakened the act. For example, he rolled again the ACA’s particular person mandate tax penalty, which incentivizes folks to enroll in medical insurance. He additionally proposed finances plans that might have minimize [about] $1 trillion from Medicaid.
[CLIP: “The Mist 4 (Instrumental),” by Kreb]
Trump’s actual plans for the ACA have been fairly ambiguous. Throughout his marketing campaign he’s implied he would maintain it and make it stronger. Different instances he’s promised to exchange it with one thing higher. Once more, throughout that September debate he mentioned he had “ideas of a plan” however then provided no particulars.
Trump’s working mate, J. D. Vance, gave some extra particulars on what Trump’s plan may probably seem like. What he described was probably drastic adjustments in insurance coverage threat swimming pools. Consultants have mentioned that his proposal may make protection cheaper for these with fewer medical wants however far more costly for these with increased ones. So this would possibly undo the ACA’s protections that forestall insurers from discriminating towards folks with disabilities or preexisting situations, in addition to people who find themselves pregnant.
Harris has made it fairly clear that she’d shield and strengthen the ACA. Harris has additionally strongly highlighted a proposal to waive medical debt from folks’s credit score experiences. She additionally just lately launched plans to supply extra funding help by means of Medicare for at-home well being aides and long-term well being care wants for seniors. If this passes, it might be the primary time ever Medicare would cowl these advantages.
[CLIP: “Pushing Forward (XO Edit) (Instrumental),” by Ballinger]
So there’s so much on the desk this election in terms of well being care. Finally, the following president goes to have a considerable affect on how you’ll be able to obtain well being care and the way a lot it’s going to value you.
Feltman: Well being care could be the obvious concern the place science coverage and on a regular basis life intersect, however it’s removed from the one subject on the poll this 12 months. So let’s pivot to one thing utterly completely different: nuclear proliferation.
Dan Vergano: My title is Dan Vergano. I’m a senior opinion editor at Scientific American. And I’ve been writing concerning the nuclear weapons coverage elements of the 2024 election.
[CLIP: “Lead,” by Farrell Wooten]
So amongst nuclear coverage consultants, the massive shock of this marketing campaign has been how little dialogue there was of nuclear weapons. There’s so much happening: Vladimir Putin has been waving the nuclear sword round for the final three years. We’re spending some huge cash on nuclear modernization within the U.S., and there’s been surprisingly little dialogue of what’s a fairly essential matter.
Whoever wins this election faces actual deadlines by way of coping with nuclear weapons. In 2025 the Iranian deal limiting them from creating nuclear weapons expires. We’ve already pulled out from that deal, however the Europeans and the Iranians have stored it going. And the worry is that except we give you one thing to exchange that, that there’ll be a “nuclear breakout,” they name it, which implies Iran getting the bomb, within the Center East, and that may result in all people else there getting it, and the world turns into an exponentially extra harmful place.
After that, then 2026, they should take care of the expiration of a deal between the U.S. and Russia to restrict our nuclear warheads, which has stored the world protected for many years. And so the potential there may be for the numbers of nuclear warheads that each of the 2 largest superpowers on the planet, by way of nuclear arms, possess to start out ratcheting again up once more and making the world an much more harmful place—one of many triumphs of the Chilly Struggle ending. So these are gonna face whoever the winner of the election is.
[CLIP: “Beautifully Moody Piano (Instrumental),” by Stephen Boda]
So going largely off the Biden administration’s document, the expectation is that Harris would attempt to make use of diplomacy first to proceed these treaties, primarily to kick the can down the highway to maintain them in impact and to restrict the variety of warheads the U.S. and Russia should construct and pay for. On Iran, Harris just lately mentioned she would search diplomacy first however that each one choices had been on the desk; which means the specter of army motion to forestall Iran’s nuclear breakout.
With Trump his document is certainly one of blustering, primarily, to attempt to get higher offers with different nations and it not figuring out. He tried to interact China and Russia in an extension of the treaty limiting nuclear weapons deployments, and that didn’t work out in any respect. It was type of a last-minute factor for the Biden administration, as quickly because it got here in, to maintain that deal alive. [Trump] doesn’t appear eager about persevering with it. With Iran he pulled out of the sooner deal and, once more, doesn’t appear eager about making a take care of them, in order that would appear to result in Iran getting the bomb. There’s some hopes that we may in some way overawe them with our army energy, however that hasn’t labored up to now.
So the elephant within the room is Trump’s temperament. He talked about “hearth and fury” with North Korea again in his administration and alarmed lots of people, then had a rapprochement with North Korea that ended up yielding nothing by way of a deal. North Korea has since elevated its variety of warheads. And the query is: Is he any extra secure now than he was then? He appears genuinely involved about nuclear battle and has spoken at instances about fears of “World Struggle III.” He talked about it within the debate.
[CLIP: Donald Trump speaks at September’s presidential debate: “We have wars going on in the Middle East. We have wars going on with Russia and Ukraine. We’re gonna end up in a third World War, and it’ll be a war like no other because of nuclear weapons, the power of weaponry.”]
Vergano: However, you recognize, he famously makes his choices from the intestine, is an impulsive chief. This sometimes isn’t what you need in a nuclear weapons setting; you need clear signaling and predictable responses that everybody can perceive. That’s form of been what we’ve been making an attempt to do since 1953.
Voters ought to know that proper now we’re spending some huge cash on nuclear modernization. It’s a $2 trillion deliberate program over 30 years, and that’s double the associated fee that it was initially promised for us again within the Obama and Trump administrations. So we’re spending some huge cash on nuclear weapons. Regardless of who wins, that appears bent on getting ahead, and nobody is discussing whether or not that’s a good suggestion or not.
Mission 2025, which is seen as signaling the course the Trump administration would take, requires a way more aggressive program than the one we have already got. It could improve the variety of weapons, and it might resume testing of nuclear weapons, which we haven’t performed since 1992, which was seen as a approach of ratcheting down the nuclear menace. And it’s not clear what profit there could be to that testing. It’s one thing that protection hawks have form of known as for for some time, however it’s not one which form of would settle the temperature of the world.
[CLIP: “Anchor (Instrumental),” by Stephanie Schneiderman]
The take-home is that so much is happening in nuclear weapons, and voters aren’t actually excited about it or listening to about it. You must know {that a} program is continuous that’s gonna spend some huge cash on this, and the query is a matter of diploma: Would you like an aggressive program or would you like a merely busy one happening? There doesn’t appear to be plenty of questioning of the function of nuclear weapons on the planet, which is fairly curious as a result of they’re essential.
Feltman: That’s all for right now’s episode, however we’ve received extra election protection coming your approach. Keep tuned for half two on Monday, which we’ll be airing rather than our standard information roundup. We’ll hear from a couple of extra Scientific American editors to be taught the place Trump and Harris stand on local weather, power, gun violence, schooling and immigration. And, sure, all of these are science and well being coverage points. So for those who’re undecided how, positively tune in.
[CLIP: Theme music]
Science Rapidly is produced by me, Rachel Feltman, together with Fonda Mwangi, Kelso Harper, Madison Goldberg and Jeff DelViscio. This episode was reported and co-hosted by Tanya Lewis, Lauren Younger and Dan Vergano. Shayna Posses and Aaron Shattuck fact-check our present. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for extra up-to-date and in-depth science information.
For Scientific American, that is Rachel Feltman. Have an important weekend, and don’t overlook to vote!
