With this abridged overview, MedPage Today examines the health policy records of the Republican and Democratic vice presidential nominees, Sen. JD Vance (R-Ohio) and Minnesota Gov. Tim Walz (D).
Abortion, Reproductive Health
Vance’s stance:
During a debate in October 2022 when Vance was running for Senate, he signaled an openness to a 15-week national abortion ban, with exceptions for rape, incest, and the life of the mother. However, in 2021, he argued against such exceptions, stating that “two wrongs don’t make a right.”
In January 2023, Vance signed a letter calling for the Department of Justice to leverage the Comstock Act, a 19th-century anti-vice law, to prohibit the mailing of abortion pills nationally. But last month, the Ohio senator walked back those views, stating his alignment with former President Trump’s stance that abortion is a state issue.
As a senator, Vance sponsored at least seven anti-abortion bills, including bills to defund Planned Parenthood, and a so-called “born-alive” bill to prohibit healthcare providers from failing to provide proper care to a child who survives an abortion attempt.
Vance also voted against legislation that would have protected rights to in vitro fertilization and other fertility treatments nationally.
Walz’s stance:
When it comes to reproductive healthcare, Walz’s motto is “mind your own damn business.”
In January 2023, Walz became the first governor to sign a bill to enshrine abortion in its state’s constitution and maintain the state’s current protections, following the reversal of Roe v. Wade.
Then in March of that year, he signed a shield law protecting patients and healthcare professionals who receive and provide abortions, respectively, from legal actions by out-of-state law enforcement and other actors.
In speeches, Walz has shared his and his wife, Gwen’s struggle to get pregnant, and how they turned to fertility treatments, which led to the births of both of their children.
When Kamala Harris became the first vice president to visit an abortion clinic in Minnesota, she was accompanied by Walz.
Why It Matters:
According to polling by the Pew Research Center, 63% of adults in the U.S. support abortion in all or most cases. Furthermore, in at least seven different states where abortion has been on the ballot (including conservative states like Kansas, Montana, and Kentucky), voters have come down on the side of abortion rights.
Healthcare Reform, Healthcare Costs
Vance’s stance:
In 2017, Vance wrote an editorial in the New York Times criticizing Republican attempts to repeal the Affordable Care Act (ACA), arguing “in the rosiest projections of each version, millions will be unable to pay for basic health care.”
In a 2022 interview with AARP, Vance voiced support for allowing Medicare to negotiate drug prices and for importing drugs from overseas; however, he blasted Vice President Harris for casting the deciding vote on the Inflation Reduction Act that included the drug price negotiation measure, which he called the “green energy scam.” (Vance is a climate change skeptic.)
In 2023, Vance co-sponsored a bipartisan bill to cap the cost of insulin at $35 per month.
He also introduced a bill that aimed to exclude federal taxpayer dollars funneled through ACA waivers from being used to provide health insurance plans for “Dreamers” — also known as DACA recipients.
Walz’s stance:
When Walz was 19, his father died of lung cancer, sending the family into medical debt and forcing his mother to return to work. That experience stayed with him and inspired subsequent policy efforts.
As a member of Congress in 2010, Walz voted for the ACA and voted against repeated attempts to repeal the law.
As governor in April 2020, he signed the Alec Smith Insulin Affordability Act, which capped co-pays for a month’s supply of insulin at $35 — the bill was named after 26-year-old Smith who died in 2017 after rationing his insulin.
Walz also secured a path for Minnesotans to a public option; however, the plan has faced budgetary challenges and is currently slated to take effect in 2027.
In 2023, Walz came under fire for failing to get two major bills approved — one that might have significantly reduced healthcare costs and the other that aimed to improve hospital staffing. After the Mayo Clinic threatened to redirect billions of dollars in investments to other states, Walz and other proponents of the bill walked back the measures, agreeing to milder versions of both and drawing blistering criticism from the Minnesota Nurses Association for “his abdication of good government and acquiescence to anti-democratic and anti-labor corporate bullies.”
In June, Walz signed legislation that banned medical providers from withholding medically necessary care because of unpaid medical debt and blocked medical debt from impacting patients’ credit scores.
Why It Matters:
People without access to health insurance are more likely to postpone or forgo medical care, including preventive care and treatment for chronic conditions.
Approximately 20 million people in the U.S. owe medical debt and about 14 million owe more than $1,000 in medical debt, according to an analysis from the Peterson-KFF Health System Tracker.
LGBTQ and Transgender Care
Vance’s stance:
Sofia Nelson, a former friend of Vance’s who had a gender transition-related surgery, said Vance was initially supportive of their transition and brought them baked goods after their surgery, but when Vance sought a Senate seat, his views changed.
In July 2023, Vance introduced the Protect Children’s Innocence Act, which would have blocked all taxpayer funding for gender-affirming care, including non-surgical options such as puberty blockers and hormone treatments, making such practices a felony; the bill would have punished healthcare providers with up to 15 years in prison.
Walz’s stance:
Before serving as a lawmaker, Walz was a teacher and football coach, who was chosen by his Minnesota high school to be the faculty adviser for the school’s first Gay-Straight Alliance. In 2009, Walz supported the repeal of Don’t Ask, Don’t Tell, the policy blocking gay and lesbian individuals from serving openly in the military.
In March 2023, he signed an executive order to protect the right to gender-affirming care for Minnesotans and individuals from other states, and to keep them, their families, and providers safe from legal repercussions for traveling to Minnesota to receive such care. Walz also signed a bill prohibiting conversion therapy — the practice of trying to alter an individual’s sexual orientation or gender identity that is opposed by the American Psychological Association, the American Academy of Pediatrics, and other medical groups.
A month later, he signed what’s been dubbed a “Trans Refuge” law that protects LGBTQ individuals’ access to gender-affirming care, including surgeries and puberty blockers, free from the interference of out-of-state laws.
Why It Matters:
To date, half of all states in the country have enacted laws that ban certain healthcare services for transgender children.
Research suggests that gender-affirming medical interventions may help prevent suicide among transgender and nonbinary youth.
Opioid Epidemic
Vance’s stance:
In his memoir, “Hillbilly Elegy,” Vance wrote about his experiences growing up as the son of a mother with a heroin addiction. He has repeatedly blamed President Biden’s border policies for the surge in fentanyl in America’s heartland, including during his speech at the Republican National Convention.
However, Vance has been criticized for his flawed efforts to address the crisis. A Business Insider investigation found that the anti-opioid nonprofit he started spent more on “management services” than actual programs targeting opioid addiction.
Recovery advocates who worry that a second Trump term might lead to a decreased focus on treatment have said they are relieved to see Vance’s support for treating substance use disorders as health conditions.
Vance also co-sponsored a bill to reclassify fentanyl as a Schedule 1 drug, which has not passed; however, another bill he supported to help tackle fentanyl trafficking was signed into law in April.
Walz’s stance:
In April 2022, Walz established an interagency subcabinet and advisory council to identify strategies to better treat and support people with substance use disorders.
A month later, Walz approved a bill to channel $300 million from a multi-state opioid settlement into the state’s opioid response fund, which is used for opioid addiction education, prevention, treatment, and recovery programs.
In May 2023, Walz signed a bill legalizing adult-use cannabis, which called for the expungement or re-sentencing of cannabis-related convictions.
Why It Matters:
According to provisional data from the CDC, there were an estimated 107,543 drug overdose deaths in the U.S. in 2023, a 3% drop from 2022, reflecting the first annual decline in overdoses since 2018. Approximately 74,702 of those deaths were from fentanyl and other synthesized opioids.
Public Health
Vance’s stance:
In September 2023, Vance introduced a bill prohibiting taxpayer dollars from being used to enforce mask mandates outside of the healthcare sector; while that bill failed, Vance succeeded in amending an appropriations bill blocking the Department of Transportation from using federal funds to enforce mask mandates, which he called “an outrageous overstep by the public health establishment.”
Walz’s stance:
Walz was taken to court over his use of emergency powers during the COVID-19 pandemic — including restricting public gatherings, mandating mask wearing, and limiting business operations — and won.
In 2023, Walz signed a bill to provide universal free breakfasts and lunches for children in K-12 public schools. Meanwhile, he’s been criticized for his failure to prevent a broad COVID-era fraud scheme that exploited the state’s nutrition programs.
Why It Matters:
Trust in public health experts and physicians waned during the pandemic. There are more than 30 different pathogens that could spark a future pandemic, including mpox, avian flu, and dengue virus, according to the WHO.
Gun Violence
Vance’s stance:
In his speech at the Republican National Convention, Vance recalled how his “Mamaw” kept a giant stash of loaded guns everywhere in her house. The National Rifle Association (NRA), Gun Owners of America, and the National Shootings Sports Foundation all praised his record.
Vance has opposed “red flag” gun laws — measures that allow law enforcement to seize firearms from anyone that a court deems dangerous to themselves or others — and bills that would prohibit certain types of automatic rifles. He also supports the establishment of a national stand-your-ground law.
Walz’s stance:
While in Congress, Walz voted in favor of several measures to expand access to firearms, including a bill to allow veterans deemed mentally incompetent to purchase firearms, and scored “A” ratings from the NRA. In 2016, Guns & Ammo magazine named Walz as one of the top 20 politicians for gun owners.
Walz’s views changed following the 2018 shooting at Marjory Stoneman Douglas High School in Parkland, Florida, and after his daughter pleaded with him to address the issue. While campaigning for governor, Walz wrote an op-ed in the Minnesota Star Tribune, stating that he would no longer accept contributions from the NRA. In 2023, he signed a gun safety law that included background checks and a “red flag” law.
Why It Matters:
More than 40,000 people died from gun violence in the U.S. in 2023. Firearm sales increased during the pandemic, with roughly one in five households purchasing a firearm from March 2020 to March 2022.
Shannon Firth has been reporting on health policy as MedPage Today’s Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. Follow
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