WASHINGTON — President Biden is ending his bid for a second term in office and backing Vice President Kamala Harris to take the nomination, he announced Sunday. While Harris shares similar views as Biden on many issues, she is to the left of the president on health care.
“I believe it is in the best interest of my party and the country for me to stand down and focus solely on fulfilling my duties as president for the remainder of my term,” the president wrote in a letter shared to social media.
The announcement comes after weeks of speculation about his physical health and cognitive abilities following a stumbling performance in the June 27 debate against former president Donald Trump, where among other gaffes and inaccuracies, Biden incorrectly said “we beat Medicare.”
His announcement leaves the Democratic Party with weeks before its late-August convention to secure a presidential nominee and restart the 2024 campaign. Biden in his letter thanked Harris “for being an extraordinary partner in all this work” and in a later post to X said he was endorsing her for the party’s nomination.
“My very first decision as the party nominee in 2020 was to pick Kamala Harris as my Vice President. And it’s been the best decision I’ve made,” he wrote. “Today I want to offer my full support and endorsement for Kamala to be the nominee of our party this year. Democrats — it’s time to come together and beat Trump. Let’s do this.”
Later Sunday, Harris issued a statement saying she would seek the Democratic nomination for president. “I am honored to have the president’s endorsement and my intention is to earn and win this nomination,” she said.
The president announced last Wednesday that he had been diagnosed with Covid-19. An hour before he dropped out Sunday, his doctor shared an update on Biden’s health, saying his symptoms had improved significantly.
Biden’s endorsement of the vice president to replace him as the Democratic Party’s presidential nominee underscores the rise of a more liberal approach to health care policy.
By far Harris’ strongest health care issue, if the party backs her at the August convention, will be her high-profile position in the White House advocating for reproductive rights following the fall of Roe v. Wade. She was the first vice president to visit an abortion provider. Unlike Biden, who earlier in his political career held anti-abortion views, Harris has been consistent in her support of access to abortions.
When Harris challenged Biden in 2020, she worked to carve out a lane in between Biden’s appeal to moderates and the far-left progressive campaigns of Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.). While that wasn’t a successful strategy, that campaign, her history as a California senator and attorney general, and her tenure as vice president hint at her vision for health care.
She has positioned herself as tougher on the health care industry than Biden by endorsing a transition to Medicare for All (though she still envisioned some sort of role for private plans). She called for more aggressive drug pricing policies than Biden has been willing to employ, such as linking U.S. prices to ones negotiated by other wealthy nations.
In the Senate, she distinguished herself as a champion for maternal health, and was the lead Senate sponsor of a legislative package dubbed the Black Maternal Health Momnibus Act. Harris spoke about the urgency of addressing the maternal care crisis in an interview with STAT in April 2021.
Of course, there’s a chance that Harris is not ultimately the nominee, depending on how delegates vote at the Democratic National Convention, which is scheduled for Aug. 19-22 in Chicago. Party officials have discussed holding a virtual delegate vote before the convention.
Plus, the extent of Harris’ ability to influence policy will hinge on which party controls the House and Senate following November’s elections.
Women’s health
Following the downfall of Roe v. Wade, Democrats have counted on outrage about attacks on abortion access and reproductive rights more broadly, including access to contraception and procedures like IVF, to motivate their base to turn out in November.
And no one has been more visible in the White House on the issue than Harris. She’s held Washington roundtables and rallies across the country during a “Reproductive Freedoms Tour.”
“This is not just an attack on women’s fundamental freedoms. It is an attack on the very foundation of our public health system,” Harris told reporters in 2023 ahead of Supreme Court arguments on the fate of the abortion pill mifepristone.
The efforts follow on her time as a senator, when Harris introduced legislation to shore up reproductive health care access and grilled then-nominee to the Supreme Court Brett Kavanaugh on his stance, asking the judge whether there were any laws that give the government power to make decisions about the male body. She also questioned Biden during a 2019 primary debate about his longtime support for the Hyde Amendment, which bars federal funding for abortion procedures. Biden that year had changed his stance and during his presidency sought to remove the provision from federal budget bills.
On the campaign trail this week, Harris continued to hammer Republicans on reproductive rights, including Trump’s vice presidential pick JD Vance, who opposes abortion but somewhat softened his stance in recent weeks by supporting access to mifepristone.
“You cannot claim you stand on unity if you are intent on taking reproductive freedom from the people of America and women of America, trying to ban abortion nationwide…and restrict access to IVF and contraception,” she told rallygoers in North Carolina the day after Vance’s convention speech.
Harris also made addressing maternal mortality in the United States one of her marquee issues as a senator, leading in the Senate on bicameral legislation addressing the issue. The package included measures that would have extended Medicaid coverage for new mothers to one year after birth, improve data collection, diversify the maternal health workforce, and provide funding to community-based organizations.
In an interview with STAT on the issue, Harris touted the administration’s gains in health insurance as particularly impactful, as Black women are more likely than white women to lose their health insurance at some point during their pregnancy.
Medicare for All
While Biden favored offering a public health insurance option on Affordable Care Act exchanges during his 2020 campaign, Harris supported transitioning to a Medicare for All system — albeit one with a role for private insurance, and over a longer timeframe than progressives envisioned.
Harris in a Medium post laid out her vision for Medicare for All. First, she proposes expanding Medicare’s services to include vision care, dental care, hearing aids, mental health services, substance use disorder treatment, and comprehensive reproductive health care services.
She also outlines maintaining a role for private insurers, as long as they follow rules set by Medicare.
“This preserves the options that seniors have today and expands options to all Americans, while also telling insurance companies they don’t run the show,” Harris wrote.
However, it’s unclear how aggressively Harris would or could pursue a Medicare for All transition in the White House. Even progressive Democrats in Congress have backed off of calling for Medicare for All as a top priority, given the political headwinds on Capitol Hill that made even Biden’s public option a functional impossibility.
Drug pricing
As a presidential candidate, Harris echoed former President Trump’s desire to ensure that the United States doesn’t pay more than other countries for prescription drugs. Part of her proposal would cap U.S. drug prices at the average of other developed countries like Japan, the United Kingdom, and France.
“As president,” Harris’s campaign wrote on its website, “she’ll require pharmaceutical companies to set fair prices for prescription drugs and tax profits made from abusive drug prices at a rate of 100 percent.”
She also promised to exercise so-called “march-in rights” to allow competition for drugs that were developed using federal research, a measure that the National Institutes of Health has declined to use on the basis of price during the Biden administration.
Another part of Harris’ plan that aligns more closely with Biden’s record is a proposal to limit payments for drugs whose prices rise faster than the rate of inflation. Biden implemented some limits on drug price hikes as part of the Inflation Reduction Act’s drug pricing reforms, but that law only applied the restrictions to Medicare, not the commercial insurance market.
Currently, conversations on Capitol Hill about prescription drug affordability have largely focused on the role of middlemen called pharmacy benefit managers. Biden has proposed increasing the scope of the program passed in the Inflation Reduction Act to include more drugs, and expanding parts of the law like limits on drug price hikes and out-of-pocket caps to the commercial insurance market, too.
Antitrust
Before she served in the Senate, Harris clashed with heavyweights in the health care industry as attorney general of California.
Perhaps her most high-profile attack came when she was one of 11 states to sue to stop a $54 billion merger between Anthem and Cigna in July 2016. One of Harris’ arguments against the Anthem-Cigna deal was that it would give insurers too much power to drive down pay rates for providers in six California markets. The deal fell apart in 2017.
Harris’ merger oversight got political in 2015 when she stood between Prime Healthcare Services, a for-profit hospital chain, and a safety-net system they tried to acquire. She technically approved the merger, which unions opposed, but put more than 300 conditions on it. The system’s CEO, Prem Reddy, is a Trump donor and personally sued Harris for blocking the merger to advance her political interests. A federal district court dismissed the lawsuit in 2017.