Harris said in the ad that Trump would eliminate Medicare and pre-existing condition coverage. Here are the facts

Vice President Kamala Harris makes her closing argument for the presidency in a new TV ad attacking former President Donald Trump on health care, entitlements and taxes.

“What would Trump’s second term be like? These are all included in his 2025 Project agenda.” the narrator says. “It would allow insurance companies to deny coverage for pre-existing conditions, cut Social Security and Medicare, and give tax breaks to billionaires.”

Harris’ months-long campaign has tied Trump to Project 2025, a 900-page handbook of policy recommendations for the next Republican administration created by the conservative Heritage Foundation think tank.

There significant overlap Between people involved in the project and former Trump administration officials. But Project 2025 is not part of Trump’s 2024 agendaand it worked for: distance yourself from him.

With that in mind, the ad is a mixed bag of accuracy. It references Trump’s previous claims to repeal the Affordable Care Act, misleads viewers about “cuts” to entitlement programs popular with older Americans, and ignores that Americans with average incomes will also receive some tax cuts under the Trump administration.

Here are the facts about each of the claims in the ad:

What do Trump and Project 2025’s plans say about pre-existing conditions?

Harris’ campaign pointed to the actions and comments of Trump and her running mate, Senator J.D. Vance, regarding the repeal of the Affordable Care Act to support her claim that Trump would allow insurance companies to deny coverage to people because of pre-existing health conditions . The 2010 health law signed by former president Barack Obama requires insurance companies to cover people with pre-existing conditions.

Trump promised to repeal the Affordable Care Act in his 2016 presidential campaign, and as president he supported congressional Republicans’ failed repeal and replacement efforts.

Trump’s stance has gone back and forth during the 2024 campaign. From time to time he said that he wanted to replace the law with a “alternative.” But in March, he wrote He said on Truth Social that he is “not a candidate to kill” the law and instead wants to make it “better” and “cheaper.” Trump during the September 10 presidential debate with Harris in question He has “the concept of a plan” to replace the law, but he will “execute it as well as possible” before coming up with his own plan.

More than 1,500 doctors published a letter Oct. 17 called on Trump to release details on how he would change the ACA, saying voters needed the clarification so they could make an informed decision.

Vance explains some of these details in a September 15 interview He said on NBC News’ “Meet the Press” that his administration would deregulate insurance markets but still “make sure that pre-existing coverage — conditions — are covered.” Days later, Vance came up with the idea Grouping people with chronic diseases into insurance pools according to their high risk. Risk pools refer to a group of people who share the burden of healthcare costs.

Placing chronically ill patients into higher risk pools would reverse a key pillar of health care law that largely ended the practice by requiring insurers to put all individual market enrollees in the same risk pool. This is done to control premium costs by using the lower costs incurred by healthy participants to contain the higher costs incurred by less healthy participants. According to KFF Health News. Experts say segregating sicker people into their own pool could lead to higher costs for people with chronic health conditions and potentially make insurance coverage financially out of reach.

Project 2025 does not require eliminating the ACA or pre-existing coverage protections. He proposes codifying Trump-era rules to expand them short-term, limited-coverage health care plans. Democrats call these plans “garbage insurance” and say they limit carecan charge people with pre-existing conditions more and lead to surprise medical bills.

Project 2025 won’t cut Social Security, proposes some changes to Medicare

Harris ad misleading about both Social Security plans Embers And Project 2025. Trump has said he will not cut Social Security benefits, and none of the 10 references to Social Security in his policy document outline the cuts.

In previous campaigns and before he became a politician, Trump had said about a half-dozen times that he was open to major overhauls, including cuts to Social Security and privatization. More recently, In a CNBC interview in March 2024“There’s only so much you can do in terms of benefits and deductions,” Trump said of entitlement programs like Social Security. However, he quickly walked back that statement, and his comment essentially contradicts everything else Trump has said during the 2024 presidential campaign.

Trump campaign website says He said “not a penny” should be cut from Social Security.

Project 2025 suggests changes to Medicare, including making Medicare Advantage, the private insurance offering in Medicare, the “default” enrollment option. Medicare Advantage plans have provider networks and may also require prior authorization; This means the plan can approve or deny certain services. Original Medicare plans have no prior authorization requirement.

The guidance also calls for repealing health policies such as the Inflation Reduction Act enacted under President Joe Biden. The 2022 law allows Medicare to negotiate with drug manufacturers for the first time and was recently finalized. in a deal Collaborating with drug companies to reduce costs of 10 expensive prescriptions for Medicare enrollees; The new prices will come into force in 2026.

Trump said throughout the campaign: It won’t cut Medicare.

Project 2025 and Trump have different views on taxes, but “tax cuts for billionaires” are on the table

Overall, the benefits Trump’s tax plan It would benefit most income groups while flowing disproportionately toward wealthier Americans. While Project 2025’s recommendations differ from Trump’s tax agenda, changes to the project could also lead to wealthy people paying lower taxes.

Under Trump’s administration Tax Cuts and Jobs Act of 2017Income up to $11,600 is currently taxed at 10%, income between $11,601 and $47,150 is taxed at 12%, and income between $47,151 and $100,525 is taxed at 22%. Those who earn more are taxed between 24% and 37%.

Project 2025 calls for the creation of only two income tax brackets: one at 15% and the other at 30%, eliminating most deductions, credits and exemptions. The program says the 30 percent tax rate should start “at or near the Social Security wage floor,” which is around $168,600 in 2024.

The Project 2025 plan does not specifically propose eliminating the standard deduction, which is the dollar amount taxpayers can deduct from their income before income taxes are imposed.

If this, along with most other tax cuts, were repealed, people with incomes up to $190,000 would pay a higher tax rate on all their income, while the wealthiest Americans would pay a lower tax rate.

This is not Trump’s plan. Trump says would extend Provisions of the 2017 tax law that will expire at the end of 2025. lowered taxes at least initially for all income groups; rich taxpayers benefited disproportionately. Urban Institute-Brookings Institution Tax Policy Center to create The reduction in tax rates introduced by the law for the top fifth of the income spectrum was found to exceed that for each of the other fifths.

Trump would lower the corporate tax rate Trump also made several more targeted tax cuts, including ending taxation from 21% to 15% for companies that manufacture their products in the U.S. (The 2017 law had reduced the corporate tax rate from 35% to 21%.) Social Security benefits, tips And overtime.

The University of Pennsylvania’s Penn-Wharton Budget Model projected the effects of both presidential candidates’ tax plans on various income levels in 2026.

Trump’s plan revealed will increase After-tax income for each income group. However, the bottom two-fifths of the income spectrum would earn less than 2%, the middle quintile would earn 2.1%, and the second-highest quintile would earn 2.8%. With cuts affecting the top fifth of income earners, earnings will range between 2.7% and 3.7%.

In contrast, the Penn-Wharton model of Harris’s plan will increase After-tax income was 18% for the bottom fifth, 4.8% for the second-lowest fifth, 2.7% for the middle fifth and 2.1% for the second-highest fifth. The top 5% of earners will see their after-tax income decline.

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