KFF Health Tracking Poll September 2024: Harris v. Trump on Key Health Care Issues

Key Takeaways

• Four in ten voters (38%) choose the economy and inflation as the most important issue determining their vote this fall from a list of national issues, including several health care issues. As the economy looms large in the 2024 election, voters from both parties want their candidates to talk about health care costs. When voters are asked to offer in their own words what health care issue they most want to hear the candidates talk about, about four in ten voters across partisanship mention issues related to the cost of health care. Democratic and Democratic-leaning independent voters say they would like Vice President Harris to talk about general health care costs (20%), prescription drug costs (15%), and the cost of insurance or reducing their monthly premiums (6%). About one in seven offered abortion as the one health care issue they want to hear about from Harris and 13% mentioned universal health care – an issue that was largely debated during the 2020 Democratic primaries. Similarly, nearly half (45%) of Republican voters and Republican-leaning independent voters say they would most like to hear former President Trump talk about health care costs. This is followed by one in eight (12%) who say they want to hear him talk about Medicare, Medicaid, or Social Security.
• Abortion continues to motivate a small group of voters, mainly Democratic and Democratic-leaning independent women voters of reproductive age (ages 18-49). About a fifth of this voting bloc say abortion is their most important voting issue and half say they will only vote for a candidate who shares their views on abortion. Overall, this group of voters wants abortion to be legal and the vast majority (90%) say they want a federal law restoring a nationwide right to abortion similar to what was protected by Roe v. Wade. The share of Democratic-leaning women of reproductive age who say they think the presidential election will have a major impact on abortion access has increased 31 percentage points in the past six months (90% v. 59%), a time in which Vice President Harris became the Democratic presidential nominee and began highlighting the issue in her campaign.
• A majority of all voters now say they trust the Democratic nominee more to handle the issue of abortion compared to President Biden (53% v. 34%), widening a much smaller advantage that President Biden had over former President Trump earlier this year (38% v. 29%), a sign of Harris’s relative strength with Democratic voters on this issue.
• Voters largely prefer a federal law restoring a nationwide right to abortion, similar to what was protected by Roe v. Wade (61%), rather than leaving it up to the states to decide whether abortion is legal or not (39%). Majorities of both Democratic voters (87%) and independent voters (68%) would prefer a federal law restoring the nationwide right to an abortion, the policy position of the Democratic presidential candidate V.P. Harris, while seven in ten Republican voters would prefer leaving abortion laws up to the states, the position advocated by former President Trump. Notably, while the vast majority of Democratic and Democratic-leaning women voters of reproductive age support restoring a federal law for a nationwide right to abortion, this policy proposal is also preferred by half of Republican women voters of reproductive age.

How Voters Are Prioritizing Health Care Issues in 2024

The economy and inflation continue to dominate the list of issues that voters are focusing on during this year’s presidential election with four in ten voters (38%) saying it is the most important issue determining their vote in the 2024 presidential race. Following the economy is threats to democracy (22%), immigration and border security (12%), then several individual health care issues including abortion (7%), Medicare and Social Security (7%), and health care costs, including prescription drug costs (5%). Altogether, health care issues are seen as the most important issue by about one in five voters (19%). Gun policy (3%) and the war between Israel and Hamas in Gaza (2%) rank the lowest among the issues included in the list provided to voters.

While substantial shares of voters across partisanship say the economy and inflation is their most important voting issue including more than half (54%) of Republican voters, the ranking of other issues are more partisan. For example, Republican voters are much more likely to prioritize immigration as a voting issue with nearly a quarter (23%) saying it is the most important issue to their vote compared to one in ten independent voters (9%) and few Democratic voters (4%). On the other hand, threats to democracy is the top voting issue for Democratic voters with four in ten (38%) saying it is their most important issue, compared to one in five independent voters (22%) and 5% of Republican voters who say the same.

Voters Want to Hear Candidates Talk About Lowering Health Care Costs

An indication of how the economy and health care consistently overlap for voters, economic concerns also rear up when voters are asked what health care issue they most want to hear the candidates talk about. Across partisans, the recurring theme is costs. Responses related to health care costs are offered by four in ten (42%) Democratic and Democratic-leaning independent voters when asked to say in their own words what is the one health care issue they would most like Vice President Harris to talk about. This includes voters who mentioned general health care costs (20%), prescription drug costs (15%), and the cost of insurance or reducing their monthly premiums (6%). About one in seven offered abortion as the one health care issue they want Harris to talk about and 13% mentioned universal health care – an issue that was largely debated during the 2020 Democratic primaries.

Similarly, nearly half (45%) of Republican voters and Republican-leaning independent voters say they would most like to hear former President Trump talk about health care costs. This is followed by one in eight voters who say they want to hear him talk about Medicare, Medicaid, or Social Security.

Health Care Issues, Including Abortion, Resonate Highest With Certain Voters

Overall, the individual health care issues included in the list loom larger for Democratic voters, as they are more than twice as likely as Republican voters to select abortion, Medicare and Social Security, or health care costs as their most important voting issue (25% v. 11%). One in five independent voters also chose a health care issue as their most important voting issue. In addition, women voters are about twice as likely as men to choose a health care issue as their most important voting issue this fall (25% vs. 12%). Democratic voters and women voters have long been more likely to prioritize health care issues than their counterparts, except for Republican voters’ focus on repealing the ACA, but this election cycle is slightly different. In the first presidential election since the Supreme Court Dobbs decision that overturned Roe v. Wade, abortion is now a top voting issue for about one in ten Democratic voters and a similar share of overall women voters.

Overall, most voters (58%) say a candidate’s position on abortion is just one of many factors that might affect their vote this year while about a quarter of voters say they will only vote for a candidate who shares their views on abortion. About one in five (18%) voters say abortion isn’t an important factor in their vote choice.

Democratic voters are more likely to say they will only vote for a candidate who shares their view on abortion (31%), but still most say it is just one of many factors (61%). The same is true among all women of reproductive age, with one in three saying they would only vote for a candidate who shares their view on abortion.

Abortion Is an Important Voting Issue for Democratic Women of Reproductive Age

While abortion may not resonate as a top voting issue for all voters, for a key group of voters – Democratic women voters of reproductive age – abortion is among the most important voting issues.

Abortion ranks as a top voting issue for Democratic and Democratic-leaning women of reproductive age (between the ages of 18 and 49), with 21% saying it is their most important issue, ranking alongside the economy (23%) and threats to democracy (25%) as their top voting issue.

Half of Democratic women of reproductive age, the group that is most likely to prioritize abortion as a voting issue, say they will only vote for a candidate who shares their view on abortion (48%), a position they hold more often than any other group. A similar share (48%) say abortion is one of many important factors, while few say abortion is not an important factor in their vote choice (4%). This group is largely in support of abortion access with nine in ten (93%) Democratic women of reproductive age saying they think abortion should be legal in all or most cases.

Vice President Harris Has Strong Advantage on Abortion, Former President Trump Leads on Economy and Immigration

Former President Trump has a clear advantage over Vice President Harris on who voters trust to do a better job dealing with two key issues: economy and inflation (52% vs. 37%) and immigration and border security (54% vs. 36%). On the other hand, Vice President Harris has nearly a similar advantage on the issue of abortion (53% vs. 34%). A KFF Tracking Poll conducted earlier this year when President Biden was still the Democratic nominee found that Biden had a smaller advantage over Trump on abortion (38% v. 29%), a sign of Harris’s relative strength with Democratic voters on this issue.

Neither candidate has a majority of voters saying they trust them more to do a better job on any of the other key voting issues asked about including Medicare and Social Security or health care costs. However, V.P. Harris does have the advantage on the issue of health care costs. Former President Trump garners more trust on the issue of the war between Israel and Hamas in Gaza, but a substantial share of voters say they trust neither candidate to do a better job of handling this issue.

Both presidential candidates are trying to garner support from independent voters and these voters give former President Trump the advantage on their top voting issue – the economy and inflation. About half of independent voters (52%) say they trust former President Trump to do a better job dealing with the economy and inflation, while a third (32%) of independent voters say they trust V.P. Harris to do a better job. V.P. Harris holds a much smaller advantage on their second most important voting issue – threats to democracy (46% vs. 37%). Across the three health care issues, V.P. Harris has a strong advantage over former President Trump among independent voters including a 36-point advantage on the issue of abortion. On the other hand, former President Trump holds a 20-point advantage on the issue of immigration and border security.

Most Voters Expect Presidential Election to Have Major Impact on Abortion Policy

Nine in ten (89%) voters say this year’s elections for president will have an impact on abortion access in the U.S., including six in ten (61%) voters who say it will have a “major impact.” One in ten (11%) voters think the election will not have any impact on access to abortion in the U.S.

Democratic voters are more than twice as likely as Republican voters (84% vs. 40%) to say the election will have a major impact on abortion access. Three-fourths (72%) of women voters of reproductive age, those most directly impacted by abortion policy in the U.S., say the presidential election will have a major impact on abortion access, rising to nine in ten Democratic and Democratic-leaning independent women voters ages 18-49. On the other hand, four in ten (43%) Republican and Republican-leaning independent women voters of reproductive age say the same.

A larger share of voters now say that this election will have a “major” impact on abortion access than the share who said so in March of this year when President Biden was still on the ballot, perhaps reflecting the current president’s uneasiness with the issue. Currently, six in ten (61%) voters think this election will have a “major” impact, compared to about half (51%) in March. Some of the largest changes have been among independent voters and Democratic voters, with 84% of Democratic voters now saying the presidential election will have a major impact on abortion access, up from 71% in March. Similarly, 58% of independent voters say the same, a 14-percentage point increase from 44% in March. The share of Republican voters who say the election will have a major impact has remain unchanged.

Democratic and Democratic-leaning independent women voters of reproductive age (ages 18-49) are also now placing a higher emphasis on this election’s impact on abortion access. In the most recent tracking poll, nine in ten Democratic women under age 50 now say this year’s presidential election will have a major impact on abortion access in the U.S., compared to just 59% who said the same in March of this year.

Six In Ten Voters Want Roe Protections Restored

Six in ten (61%) voters would prefer a federal law restoring a nationwide right to abortion, similar to what was protected by Roe v. Wade, while four in ten (39%) would prefer to leave it up to the states to decide whether abortion is legal or not in each state.

Majorities of both Democratic voters and independent voters would prefer a federal law restoring a nationwide right to abortion, with nearly nine in ten (87%) Democratic voters and two-thirds (68%) of independent voters who say so. Seven in ten Republican voters would prefer leaving abortion laws up to the states.

Nine in ten Democratic and Democratic-leaning women voters who are of reproductive age support restoring a federal law for a nationwide right to abortion, while Republican women voters of reproductive age are more divided with similar shares saying they would prefer a federal law restoring a nationwide right to abortion (49%) or leaving it up to the states (51%).

Nearly seven in ten voters who live in states where abortion is legal and available support a federal law restoring a nationwide right to abortion (68%), as do a majority of voters living in states where abortion is banned or limited (54%).

This is especially important as ten states are set to have voters cast ballots on abortion-related measures in the 2024 election. In those states, 62% of voters say they would prefer to have a federal law restoring a nationwide right to abortion similar to what was protected by Roe.

As the presidential campaigns continue, a majority of voters say it is important for the 2024 presidential candidates to talk about abortion (84%), access to birth control (79%), and in vitro fertilization, or IVF, (57%) on the campaign trail.

At least three-quarters of Democratic voters say it is either “very important” or “somewhat important” for the candidates to talk about each of these issues, as do a majority of independent voters. A majority of Republican voters agree, albeit to a lesser degree, that it is important for the presidential candidates to discuss abortion and birth control access, but less than half say the same about IVF.

At least nine in ten Democratic and Democratic-leaning women of reproductive age say it is important for the candidates to discuss abortion (97%) and access to birth control (95%) on the campaign trail, and three quarters (76%) say it is important for the candidates to talk about IVF.