Healthcare overtakes abortion in importance for swing-state voters

Vice President Kamala Harris and former President Donald Trump have spent more time this election cycle debating abortion as 2024 is the first presidential election year since the Supreme Court decision to overturn Roe v. Wade. 

But the new polling indicates that healthcare issues more broadly, such as health insurance and prescription drug costs, may be more important to voters than the culture-war issue of abortion.

Although the economy and inflation consistently rank as the most important topics across multiple polls, healthcare is also a high priority for voters, particularly in swing states.

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According to a new poll from the Washington Post-Schar School of likely voters in swing states, healthcare ranked fourth in a list of the 12 most important issues this election season. Abortion only ranked seventh.

About 55% of voters surveyed said healthcare was “extremely important,” and 28% said it was “very important.” By contrast, only 44% of respondents said abortion was “extremely important,” and 22% said it was “very important.”

Only 3% of respondents said healthcare was not an important issue in this election, compared to 15% of swing-state voters who said abortion was not a critical topic. 

Presidential campaigning on healthcare and abortion

Healthcare has played a larger role in the Harris campaign in part because of her involvement in the Biden administration’s efforts through the Inflation Reduction Act to lower prescription drug costs for seniors on Medicare. 

Harris has struggled to carve out a new identity for herself regarding health insurance since her failed 2020 bid for the Democratic nomination due to her support for Medicare for All.

The vice president has homed in on improving Medicare benefits, including coverage of home health, as well as more aggressive prescription drug price negotiation with pharmaceutical companies. She has also promised to forgive medical debt for about 15 million people who collectively owe approximately $220 billion in unpaid medical and dental bills.

Meanwhile, Trump’s most memorable impression on healthcare this season was his announcement during the debate with Harris in September that he had “concepts of a plan” to fix Obamacare.

Trump’s running mate, Sen. J.D. Vance (R-OH), came prepared to elucidate those concepts during his vice presidential debate with Gov. Tim Walz (D-MN). Vance said Trump does not want to eliminate coverage for preexisting conditions and highlighted healthcare accomplishments from the Trump presidency.

But the healthcare-adjacent topic that has received the most attention this season has been abortion, which Harris made the crown jewel of her campaign strategy since it delivered electoral victories for Democrats in 2022 and 2023 in the immediate aftermath of the Supreme Court decision to overturn Roe v. Wade. 

To a certain degree, Trump has had to play defense on abortion, shifting the focus of the national GOP away from abortion by framing it as a state-based issue and promising not to sign any federal abortion restrictions. 

Over half, 51%, of respondents to this month’s Washington Post-Schar School poll trusted Harris to do a better job on abortion compared to the 29% who said the same of Trump.

Nearly half of respondents, 46%, said they believed Harris would do a better job of handling healthcare issues compared to 36% for Trump. 

Breakdown per swing state

Perceptions of abortion as an important issue are slightly up compared to the last Washington Post-Schar School poll in May, in which only 41% of voters said the issue was “extremely important.”

The poll did not list separate polling results from each swing state, but different polling data from September corroborate the trend that voters in critical states are less concerned with abortion than other issues this election cycle. 

A New York Times-Siena College poll from September found that only 18% of Arizonans thought abortion was their No. 1 issue. Only 16% of voters in Georgia and 13% in North Carolina said abortion was their highest concern.

A different September New York Times-Siena College poll found that 14% of Nevada voters said abortion was their top priority, tied with immigration. 

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In Pennsylvania, 49% of voters in a Spotlight PA-MassINC September poll expressed concern about reproductive rights, and 41% said healthcare was also important. This poll did not ask voters to rank issues in order of importance. 

Even still, healthcare was not ranked as the No. 1 issue for voters in Arizona, Georgia, North Carolina, or Nevada in the New York Times-Siena College polls, outpaced by economic concerns. This suggests that, although it is an important topic, healthcare alone may not be motivating single-issue voters.