WASHINGTON — Former President Trump says he “will not cut one penny” from Medicare and Social Security and steps back from calls for broad national abortion restrictions, according to a summary of the Republican election platform released Monday ahead of the party’s national convention.
The 16-page document skims over health topics, focusing more on Trump’s proposals to restrict immigration and boost the economy. But the few policy stances laid out reflect the growing national discord over health care access, and potential GOP angst over revisiting the resounding failure of the fight to repeal and replace the Affordable Care Act. Trump has also softened his stance on abortion law as polls and state ballot votes show voters’ apprehension toward broad bans.
But while Trump and the Republican party are scaling back some of their less popular stances, they also signaled a plan to dramatically intensify a battle against transgender people’s health care. The platform says that Trump intends to bar federal funds from supporting gender-affirming surgeries, regardless of age, nodding to a stance that has inflamed GOP voters in recent years.
Half of U.S. states have passed bans or restrictions on gender-affirming care, particularly for minors, in recent years, according to the Human Rights Campaign. House Republicans last year attempted to insert language into spending and authorization bills that would bar federal funds for gender-affirming care, restrict minors’ access, and put limits on global nonprofits’ work in the area.
The Republican National Committee in 2020 simply renewed its 66-page, 2016 platform, so this new platform represents a small if incomplete glimpse into pivots the party is making to appeal to voters.
Here is how the platform has shifted on health care.
Abortion
While Trump and the Republican party are still boasting that his Supreme Court appointments led to the fall of Roe v. Wade’s national abortion protections, the former president has scaled back his rhetoric calling for broad restrictions to the procedure.
Some conservative advocates have called for federal abortion restrictions, but that language did not make it into the platform. The national committee underscored Trump’s belief that the decision should be left up to the states, though it said the party “will oppose Late Term Abortion,” using a phrase that is not recognized by major medical organizations.
The party said it would also support policies that advance prenatal care, access to birth control, and in-vitro fertilization. IVF recently became enmeshed in the fight over abortion, after Alabama’s Supreme Court issued a ruling that effectively made the fertility procedure illegal in the state.
The 2016 platform explicitly called on Congress to enact a 20-week abortion ban. It also said GOP lawmakers should bar minors from traveling across state lines for the procedure without parental consent, and called for reinstituting the so-called Mexico City Policy, which prohibits federal funding for nonprofits that provide or promote abortion services in other countries.
Sixty-three percent of Americans believe abortion should be legal in “all or most cases, according to May polling from Pew Research Center.
Medicare’s future
The new platform seems to reflect growing concerns that Republicans could raise retirement ages and alter benefits, as the Republican Study Committee recommended in a proposal this year.
The party in 2016 wrote that “[t]o preserve Medicare and Medicaid, the financing of these important programs must be brought under control before they consume most of the federal budget, including national defense,” and “Medicare’s long-term debt is in the trillions.” The 2016 platform called for raising the age of Medicare eligibility.
The platform released Monday vows that President Trump will not cut Medicare funding but will “ensure Economic Stability.” It does not go into detail on those stability provisions, but promises no cuts and no changes to the retirement age.
Medicare’s hospital fund is projected to reach insolvency in 2036, which was five years later than the previous projection.
Health care costs
Health care and prescription drug costs “are out of control” according to the platform, which does not engage with the Biden-era law allowing Medicare to directly negotiate drug prices.
Republicans “will increase Transparency, promote Choice and Competition, and expand access to new Affordable Healthcare and prescription drug options,” according to the platform.
Trump and Biden sparred over drug pricing policies in the June debate — both taking credit for insulin cost caps passed broadly during Biden’s presidency — while avoiding the ultimate question of what Trump would do with the nascent Medicare negotiation program in a second term. If Republicans were to roll back parts of the Medicare drug price negotiation program, it would likely cost the federal government money.
Though it wasn’t mentioned in this year’s GOP platform, Trump promised a year ago to sign an executive order that “will tell Big Pharma that we will only pay the best price they offer to foreign nations, who have been taking advantage of us for so long— the United States is tired of getting ripped off.”
Notably, the platform doesn’t mention Medicaid or the Affordable Care Act at all. In 2016, Trump ran on calls to repeal the ACA, and his platform advocated for Medicaid block grants, a method of funding the program that could lead to significant cuts.
Gender-affirming care and LGTBQ policy
The Republican platform reflects a yearslong effort to restrict or fully bar gender-affirming care. It pledges to ban taxpayer funding for gender affirming surgeries, and mentions restrictions on transgender people in sports and education.
While many state laws in recent years aim at limiting minors’ access to transition-related care, the 2024 platform lays out no age restrictions, seeking to prohibit federal funding regardless of patients’ age. (In the 2016 platform, the word ‘gender’ does not appear at all.)
The Supreme Court last month agreed to hear a case on state bans’ on care for transgender minors; it could hear arguments as early as this fall.
More than 60% of American voters oppose bans on gender-affirming care for minors, according to Gallup polling this year.
The shortened, 2024 platform also removes language condemning same-sex marriage. It instead says that “Republicans will promote a culture that values the sanctity of marriage” and “the foundational role of families.”