Americans who voted to elect Donald Trump as the 47th president in Tuesday night’s election expressed concerns on several major issues, including the state of democracy, the economy, immigration and foreign policy.
The state of democracy in particular was the most important issue to voters, with 35% saying so according to a preliminary ABC News poll, followed by 31% who said the economy was the most important question to them.
Health care, however, does not appear to be a major voting issue for many Americans. Even though abortion, for example, was among the top five most voted on issues, only 14 percent said it was their most important issue, according to exit poll results.
Experts told ABC News that despite concerns over the repeal of the Affordable Care Act (ACA) and new restrictions on abortion rights, other issues are a priority for Americans.
“Health issues are always a concern for people, but there were certainly other issues that were more important to people at that time,” said Dr. Perry Halkitis, dean of the School of Public Health at Rutgers University in New Jersey, to ABC News. . “It seemed like the economy and migration were the biggest issues, but especially the economy. People expressed very serious concerns about pricing, very serious concerns about affordability of products, very serious serious concerns about inflation.”
“And these concerns exceeded concerns about access to health care and/or reproductive rights, and many people voted based on their pocketbooks rather than their rights and access to health care,” Halkitis continued .
Former Republican President Donald Trump and former first lady Melania Trump leave the stage during an election night event, November 6, 2024, in West Palm Beach, Florida.
Evan Vucci/AP
Affordable Care Act
During his first term, President Trump repeatedly attempted to repeal the ACA, but was unsuccessful. He promised to replace him by the end of November 2023, saying Republicans “should never give up” on their efforts.
However, throughout 2024, Trump has repeatedly stated, both on social media and during the presidential debate, that he wants to make the ACA “better” rather than replace it.
Ultimately, concerns over health care and potential changes to the ACA failed to even resolve the top five voting issues in ABC News exit polls.
Halkitis said he doesn’t think there will be any sweeping changes to the ACA during Trump’s second term because they are “rooted in people’s lives.” However, he is concerned about laws or policies that could limit the types of services available from health care providers, as opposed to a complete repeal or dismantling of the ACA.
“One example is in the state of Texas, about a year ago, the district court ruled that pre-exposure prophylaxis, which is taking a pill once a day to prevent HIV, should not be covered by health insurance from a particular company,” Halkitis said. “I think things like that, which reflect people’s beliefs, whether they’re correct or incorrect, [that] may affect the types of health care services provided to people, if the president-elect should make changes to the Affordable Care Act.
Another example is the federal guarantee of contraceptive coverage. Under a provision of the ACA, most private insurance plans must cover the full cost of most contraceptives, such as birth control, without requiring patients to pay out of pocket.
If the new Trump administration allows employers and schools to use religious and moral exemptions to prevent coverage of contraceptives, as the White House did during Trump’s first term, this could result in out-of-pocket costs that would make contraceptives unaffordable for some, some experts. told ABC News.
People with pre-existing conditions could also be at risk. Under the ACA, insurers cannot charge more or deny coverage to someone or their child because of a pre-existing health condition. However, Vice President-elect JD Vance has suggested placing people with chronic illnesses in separate risk groups, which could increase premiums for those with pre-existing conditions.
“I hope that doesn’t happen because that would actually be disastrous for millions of Americans,” Halkitis said. “I think if they changed the pre-existing conditions provision and put people in a different bracket, it could become unaffordable for people to have health insurance.”
Dr. Stephen Patrick, professor and chair of the Department of Health Policy and Management at the Rollins School of Public Health at Emory University in Georgia, said he believes voters in the upcoming election will be motivated to turn out to the polls if they saw changes in the health care system. ACA.
For example, Patrick said public opinion generally favors provisions such as allowing parents to keep their children on their insurance plan until age 26, as revealed by a 2019 KFF health tracking poll, which might have spurred people to the polls in the past. elections.
“We know that when you start making changes to things like the Affordable Care Act, people care when we start changing things, or changing things when it affects their health insurance,” he said. Patrick told ABC News. “If you tell someone to keep your child covered by your health insurance until age 26, people are generally supportive of those types of policies.”
Reproductive rights
Some political strategists believed that the 2022 U.S. Supreme Court decision overturning Roe v. Wade would push pro-abortion rights voters at the polls to vote for Kamala Harris. Trump himself took credit for the decision, boasting that he “was able to kill Roe v. Wade.”
Signs in support of Proposition 139, the abortion rights initiative, are displayed in the lobby of the Tucson headquarters of Arizona List, an association created to empower and elect pro-progressive Democratic leaders. -choice, in Tucson, Arizona, on October 13, 2017. 16, 2024.
Olivier Touron/AFP via Getty Images, FILE
While supporters of legal abortion have consistently come out in favor of Harris, Trump’s states’ rights approach seemed to resonate with voters who did not view abortion access as incompatible with a Trump presidency.
In Arizona, 23% of people who voted “yes” on the state’s initiative to enshrine abortion rights in the state constitution also voted for Trump. In Nevada, where another abortion rights measure was approved, 25 percent of “yes” voters also voted for Trump, according to the ABC News exit poll.
“I think what we see [in] According to exit polls, abortion was a very important issue for many voters. However, not all of these voters voted for Kamala Harris,” Dr. Leslie Kantor, professor and chair of the Department of Urban Global Public Health at the Rutgers School of Public Health, told ABC News. “I think there actually had some confusion, which was sown quite deliberately by the Trump-Vance campaign over the last few weeks, trying to convince people that in fact they don’t oppose abortion, so that the track record clearly shows that they are.
Kantor said this was evident in statements from Trump and Vance in which they said the president-elect would veto a national abortion ban if it came across his desk, or in comments from Trump in which he stated that he would not use the 150 year period. the old Comstock Act prohibiting mail delivery of abortifacient drugs.
Kantor noted that although Trump expressed pride in having appointed Supreme Court justices to overturn Roe v. Wade, he spoke out less on the right to abortion during the electoral campaign.
“In 2024, as people see the devastating consequences of the overthrow [sic] In the case of Roe v. Wade, he’s really moved away from that position and been much less clear, and the voters have been clearly less clear,” she said. “Because when you see someone say, ‘I think abortion should be legal in most cases,’ “And then by voting for someone who clearly doesn’t believe that abortion should be legal, you know people have been confused.”
Preliminary exit poll results from ABC News show that abortion was an important voting issue for young women, with about 19% of all voters saying it was their most important voting issue. significant, and this proportion reaches 42% among women under 30 years old.
Kantor further noted that she believes young women are afraid after reading news reports about women being pushed to the brink of death or dying after being denied medical care because doctors were reluctant to act due to the restrictions imposed by state abortion laws. She added that some abortion care providers are also leaving states where abortion care is restricted.
“Young women are terrified by what’s happening all over the country,” Kantor said. “The truth is it’s not even safe to have a wanted pregnancy in this country. … So I think young women are at risk of being 30 years old, maybe 25 years old, having to manage their health sexual and reproductive health with very few providers and very few rights.”
It can be difficult to access abortion services, even in states where care is now legal. In Missouri, voters enshrined the right to reproductive freedom in the state constitution, ending the state’s restrictive ban. However, abortion remains unavailable in the state for now.
“Access to services is incredibly restricted, and at some point having a right no longer makes sense if you can’t actually get the service,” Kantor said.
ABC News’ Gary Langer and Gibran Okar contributed to this report.
